Older people and hypothermia: the role of the anaesthetic nurse

An Overview of the Implications for Perianesthesia Nurses in terms of Intraoperative Changes in Temperature and Factors Associated with Unintentional Postoperative Hypothermia

Patients undergo surgery and anaesthesia on a daily basis across the United States and throughout the world. A major source of worry for these patients continues to be inadvertent hypothermia, once core temperature <36°C (96.8°F). Despite well-documented adverse physiological consequences, anaesthesia nurses continue to have a difficult task in keeping patient warmth pre-/peri-/post-surgical procedure. Thermostasis within postoperative patient necessitates the collaboration of many individuals. In order to provide safe and high-quality treatment, it is essential to use the most up-to-date data to guide therapeutic procedures targeted at achieving balance body temperature in surgical patients. Providing a review of the physiology of perioperative temperature variations and the comorbidities linked with accidental intraoperative hypothermia, this article will also provide preventive and treatment methods.

Prevention of inadvertent perioperative hypothermia

All patients undergoing surgery are at risk of developing hypothermia; up to 70% develop hypothermia perioperatively. Inadvertent hypothermia is associated with complications such as impaired wound healing, increased blood loss, cardiac arrest and increased risk of wound infection. Anaesthesia increases the risk as the normal protective shivering reflex is absent. Ambient temperature also has a major effect on the patient's body temperature. Prevention of hypothermia not only reduces the incidence of complications, but patients also experience a greater level of comfort, and avoid postoperative shivering and the unpleasant sensation of feeling cold. Nurses should be aware of the risks of hypothermia so that preventative interventions can be employed to minimize the risk of hypothermia. Preoperative assessment is essential to enable identification of at-risk patients. Simple precautionary measures initiated by nurses can considerably reduce the amount of heat lost, minimize the risk of associated complications and ultimately improve patients' short- and long-term recovery. Minimizing skin exposure, providing adequate bed linen for the transfer to theatre and educating patients about the importance of keeping warm perioperatively are all extremely important. It is also worth considering using forced-air warmers preoperatively as research suggests that initiating active warming preoperatively may be successful in preventing hypothermia during the perioperative period.

Unintentional hypothermia: implications for perianesthesia nurses

Everyday throughout the United States and globally, patients undergo surgery and anesthesia. Inadvertent hypothermia, a core body temperature less than 36 degrees C (96.8 degrees F), remains a significant concern for these patients. Although the untoward physiological outcomes are well-documented, perianesthesia nurses remain challenged with keeping patients warm before, during, and after surgery. The ability to promote normal thermal balance in surgical patients requires a team effort. Using best evidence to guide clinical practices aimed at promoting thermal balance in the surgery patient is critical to the provision of safe, quality care. This article will provide an overview of the physiology of intraoperative temperature fluctuation and risk factors associated with unintentional perioperative hypothermia, and suggest prevention and management strategies.

Inadvertent hypothermia: a literature review

While working on my first placement in the operating department recovery room, I was surprised by the frequency of patients coming into recovery with mild hypothermia, having taken their temperature on arrival. In many cases the patient did not arrive with a forced-air warming blanket, or any device other than a cotton blanket. It seemed to me that it would be more efficient, kinder and possibly more cost-effective to takesteps to prevent perioperative hypothermia rather than to treat the consequences.