26 - Perioperative Hypothermia Prevention

Description: Normal body temperature is 36.0 ° C to 37.5 ° C. Fifty to ninety percent of all surgical procedures using general anesthesia lower patient temperature below 36.0 °C, which is considered perioperative hypothermic crisis. Low body temperature has three distinct adverse implications for the patient; surgical site infections caused by vasoconstriction can lead to a decrease in perfusion to the surgical site; Cardiac dysfunction is evident in ventricular tachycardia, angina, decreased cardiac output, and dysrhythmias; and, reduced platelet function and decreased activation of the coagulation cascade lead to increased blood loss. Evidence shows that hospitals can save $7,000 to $34,000 per patient by adhering to essential components that establish and maintain patient normothermia. Does pre-warming, measured by temperature taken before, during, and after surgery over a four week period, affect rates of hypothermic crisis (Temperatures less than 36 ° C) for general anesthesia patients? Essential components of maintaining patient normothermic core temperature are: Preoperative warming thirty minutes before patient is taken to the operating room with pre-warmed cotton blankets at a temperature of 130 ° F (blanket warmer setting).Intraoperative utilization of forced air warming, pre-warmed blankets, warmed intravenous fluids, and warmed irrigation fluid (at time of surgical site irrigation).Use of pre-warmed blankets during transport to post anesthesia care unit (PACU). Baseline temperature is taken upon patient arrival to Pre-operative holding area. A core temperature reading device is placed on the patient forehead. All following temperature readings will be taken from this device. A pre-warmed blanket is placed on patients thirty minutes prior to transfer to the surgical suite. Time and patient temperature is documented upon arrival to the surgical suite. New pre-warmed blankets are placed before intubation. After intubation a forced air warming device is placed on the patient and turned on after the patient is draped. After surgery, new pre-warmed blankets are placed on patients after transfer back to stretch. Time and temperature are taken upon arrival to PACU, and another temperature is taken thirty minutes after entry to PACU. The data form sixty three patients indicate that the averages are well below national average of 70% for surgical patients receiving general anesthesia. Results of temperature show the percentage of patients that are in hypothermic crisis at certain phases of the perioperative setting.             Pre-Operative temperature = 17%             Intra-Operative temperature = 29%             PACU temperature at arrival = 37%             PACU temperature at 30minutes = 6% Preventing perioperative hypothermia involves a collaborative effort by nurses and anesthesia. Results show that pre-operative warming may have a significant effect on perioperative hypothermia in adults undergoing general anesthesia.