[jsully13]

Hello! I work in the PACU of a small hospital in Illinois. We do a lot of pre-op check-in when we are not busy, and one of our plastic surgeons is requesting preoperative warming of his breast reductions and abdominoplasties. Is the process of prewarming patients with forced-air systems a routine practice? I just started a graduate level research and statistics class, and I am planning on studying the effects of preoperative warming on patient's postoperative temperature. I guess I'm just looking to find out what other facilities are doing.

Thanks!

[Nursonegreat]

i never saw that but would be interested to see if it works...those pts come out of surgery so darn cold...94, 93.7 how can that be right??? takes forever to warm them up, FOREVER.

[KrustyTheNurse]

The reason to prewarm patients to to maintain a normothermic temperature which will, therefore, decrease the risk of post-op infections. One of the patient safety goals set by the IHI (Saving 100,000 Lives Campaign) was to decrease post-op infections - preop antibiotics, discontinuing them within 24 hours, maintaining normothermic temperature, etc. Research has shown that if a patient is prewarmed for at least 30 minutes preop, temperature is maintained throughout surgery and they continue to be warmed in PACU, the incidence of post-op infections are decreased. Leukocytes can not work properly in a cold environment so, therefore, keeping a patient's body temperature closer to normal will help to decrease their susceptibility to infection. It also helps to decrease cardiac events.

http://jama.ama-assn.org/cgi/content...?view=abstract
http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract
http://www.bairpaws.com/arizanthealt..._warming.shtml

In our PACU we use the Bair Paws gowns and the patients love it. Also the staff isn't running for warmed blankets all the time. The warmed blankets only stay warm a couple of minutes and do not maintain a patient's body temp.

[jsully13]

Thanks so much Krusty! I checked out the Bair Paws website, and the system sounds wonderful! One question- what does the OR staff do with the gown during surgery? When our patients come to recovery, their gowns (IF they are wearing them) are covered in prep solution. Let me know! Again, thanks for the info. I am going to talk to my manager about possibly implementing this change!

[nowplayingEDRN]

I have never seen pre-op warming. Depending on the Anesthesiologist they may use and upper or lower body Bair hugger which helps with the confounded low temps that I see come out of OR and into the PACU (as Nursonegreat stated, takes forever to warm them up) I also have found, although I did not do a QI on it, that the temp is directly related to blood loss too. Maybe it should become a standard of practice to do pre-op warming. Krusty, thanks for the info.

[truern]

Just sticking my nose in to say that as a tummy tuck post-op patient the SHIVERING from being frozen in PACU made the pain so much worse!! Nothing ever felt as good as that warm air rushing over my body when the nurse laid that blanket thing over me.....ahhhhhh!!

[Chilly_hands]

My facility puts warming blankets on preoperatively for surgical procedures lasting an hour or longer to maintain core body temperature. Sounds like a good study. Keep us updated.

[juliag]

Hi ... I work in a small PACU in Ontrio Canada - we do general / gyne/ ent / plastics / ortho .... so far just our major gyne patients are pre warmed ... we just started this about a month ago ... our patients were coming out of the OR (despite wrming fluids and forced air warming introp) with a temp @ 36C and lower - so to meet the standard practice we started warming for 45 min pre op @ 43 - 46 C.. it is just new to us as well but will let you know how we make out

Julia from Canada