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Healing is Coming - February 2021 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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4 2 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 2 1 When you educate staff on new patient warming protocols, break down the process into a series of easy-to-follow steps: • Have the pre-op nurse place a body-warming blanket on the stretcher. • Place the patient on the stretcher. • Put the warming gown on the patient. • Attach the warming unit to the gown and have the pre-op nurse set the temperature to "high." • Detach the warming unit when the patient is transported to the OR, and keep the detached unit in pre-op. • Have the OR nurse attach and turn on the patient's underbody- warming blanket as soon as they arrive in the OR. (This step ensures active warming contin- ues during the induction, intuba- tion, IV start, central line placement, urinary catheter insertion and placement of pres- sure site padding). • Lower the setting of the body-warming blanket during the procedure. These are the basic steps to our protocol, but we make constant tweaks and variations. For instance, even though our pre-op nurse will always set the warming gowns temperature to "high," patients often adjust that setting based on personal comfort. Patient temperatures are checked once pre-operatively via a temporal scan (across the forehead to behind the ear), and intraoperatively on a continuous basis after induction via an esophageal temperature probe. — Kathy Abbott, BSN, RN ologists about our options, we decided to prewarm neuromuscular (NM) spinal fusion patients with warming gowns. While we eventually made changes to all our orthopedic procedures, we started with this small subset of patients, a group that is signifi- cantly exposed during surgery. We'd always had trouble maintaining normothermia (core body tem- perature of 36˚C) in them, and we needed to protect this vulnerable group from the many potential adverse reactions of hypothermia — infection, poor wound healing, increased blood loss (and the poten- tial need for a transfusion), decreased renal func- tion and prolonged hospitalization. For our initial trial, the vendor provided one box of 20 gowns and three warming units free of charge. After the trial, it cost us $8.23 per gown to prewarm patients, a cost our hospital's leadership saw as a reasonable investment in safety. PROACTIVE APPROACH Active warming methods are critical components of programs designed to prevent perioperative hypothermia. ACTION ITEMS Maintain Normothermia With Ease Gregory DeConciliis

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