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Maintaining Normothermia in Surgical Settings

Over the last 5 years, research has been done on the prevention of inadvertent hypothermia in surgical settings. Adverse reactions from hypothermia are estimated to occur in 50-90% of surgical procedures and can result in anywhere from $2-7,000 in additional treatment cost per patient. A collaboration of healthcare organizations researching this have created the Surgical Care Improvement Project in order to reduce complications, and in particular, have focused on the use of warming blankets as a preventative measure.

 

Warmed blankets can help increase the mean body temperature of a patient increasing their comfort and facilitating a more positive healing environment. A drop of just 2 degrees Celsius can lead to hypothermia and is easily avoided by the use of a warming blanket.

 

What effect does hypothermia have on the patient?

Hypothermia can result in any number of consequences including increased energy usage, shivering, chance of cardiac events, poor processing of medication, delayed recovery, infection, slow healing, and respiratory distress. Often, these symptoms are not exhibited by the patient but can lead to slower healing and discomfort.

 

How hot should the blanket be?

There is fear that using a blanket warmed to 93 degrees Celsius would lead to burns on the patient's skin. However, it has since been proven by Jon K. Moon, PhD that this temperature will not affect the patient in the same way that boiling water would. This has to do with the density of the material being used, as a blanket, being less dense than the skin, would transfer less of the heat to the skin surface. Water, on the other hand, is similar to the specific heat capacity of skin and causes a greater rise to skin temperature.

 

What about patient comfort, isn't that too hot?

In an independent study in patient comfort done on the use of warming blankets by Texoma Ambulatory Surgery Center, patients were provided with warming blankets either at 110 degrees Fahrenheit or 200 degrees Fahrenheit. The study concluded two very important facts:  First, the blankets heated to 110 degrees lost most of the additional heat before being applied and would have been as effective as those stored at room temperature, whereas, the blankets heated to 200 degrees kept patient temperatures in a healthy range. Second, the increased temperature not only didn't burn the patients, but actually significantly enhanced patient comfort.