How Can Hypothermia be Prevented in Medical Settings?
Unplanned hypothermia
(a core temperature of less than 36 degrees C) can negatively impact patients in
many ways. Even mild hypothermia may contribute to complications such as:
surgical site infection, altered drug metabolism, impaired blood clotting,
cardiovascular ischemia, prolonged recovery following surgery and shivering.
It is maintained by many professionals in the field that active patient
warming is associated with normalizing patient temperature. The literature
supports the use of forced air
warming devices for normalizing patient temperature and reducing shivering.
In addition, the literature suggests that forced-air warming is associated with
reduced time in recovery. Also, it is agreed that both the perioperative
maintenance of normothermia and the use of forced-air warming reduce shivering
and improve patient comfort and satisfaction. It is recommended that
normothermia should be a goal during emergence and recovery, and that when
available, forced-air
warming systems should be used for treating hypothermia.
Inadvertent perioperative hypothermia is a common and preventable
complication of surgery. Inadvertent perioperative hypothermia is defined when
the core body temperature is drops below 360C and is associated with
poor outcomes for patients.
The possible consequences of hypothermia are:
- Increased risk of wound infection
- Increased perioperative blood loss
- Longer post-anesthetic recovery
- Postoperative shivering and thermal discomfort
- Morbid cardiac events including arrhythmia
- Altered drug metabolism
- Increased risk of pressure sores
- Reduced patient satisfaction with the surgical experience
- Longer hospital stay
Prevention of hypothermia requires the use of simple measures, such as warm
clothing, use of a duvet (comforter) or blankets preoperatively and active
warming of the patient and intravenous fluids, especially in the operating room.
A range of active patient warming devices have been designed for use in the
perioperative and critical care environment, including: electric blankets,
heated fluid filled mattresses, radiant warmers and forced air warming
devices.
A forced air warming system
is a medical electrical device used to help keep patients warm during
anesthesia and surgery. The device comprises a reusable controller and
disposable, single-use blankets.
A forced air warming system comprises a controller plus a compatible
disposable blanket. The controller contains the following components:
- Electric motor and fan
- Electric heating element
- Thermostats
- Air filter
- Hose
In operation the fan draws in air through the filter and the heating element
heats it to a selected temperature, controlled by the thermostats. Heated air
travels through the hose to the blanket, which connects to the hose nozzle.
The blanket is double layered and inflates in operation. The patient contact
surface is permeable to air and the warm air exits the blanket and moves over
the patient’s skin and transfers heat to the patient by convection.
The most significant operational factors relate to the single use blankets.
It is essential that the blankets are compatible with the controller and the
range of blankets available for the controller is an important factor in the
purchasing decision.
The blankets are bulky and require storage space.
The cost of disposable blankets is the most significant cost of forced air
warming and purchasers should make use of bulk purchasing arrangements in order
to benefit from volume discounts.
The function of the fan which drives the air flow and the high airflow in the
blanket generates significant noise. Noise in operating is a potential hazard,
because it can disturb the concentration of staff or may even interfere with
communications among the team. Small differences in noise level (a few dBA’s)
may result in significant differences in the perceived noise.
Source: http://www.medwow.com/articles/
tags : forced air warming system , forced-air warming , forced air warming devices , Unplanned hypothermia , Anesthesiology Equipment
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