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J U LY 2 0 1 4 | S U P P L E M E N T T O O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
tion.
Pay attention to the fluid product's
directions as well. The manufactur-
ers of packaged fluid provide details
on how many days a bag can be
warmed and to what temperature.
The limiting factor here is the pack-
aging: After a certain point, the bag's
material may leach into the solution it contains, so be sure to label each cabinet-
warmed bag with the date it was put in the warmer and the highest temperature
allowed. Specialized in-line fluid warming systems that attach to the IV tubing
and warm the fluid on the spot are also available.
• Employ active warming.
Lastly, don't neglect the potential effects of the surgical
environment on a patient's core temperature. Body heat is lost through the skin's
contact with a cold OR table and cold drapes, and through wind chill to the air in
the room.
The OR should be set at 26 degrees Celsius (28 to 30 degrees Celsius for pedi-
atric patients), and active perioperative patient warming is a must, whether
through cabinet-warmed cotton blankets, convective forced-air warming gar-
ments or a radiant warming device.
Rewarding results
Patients who arrive normothermic in PACU rewarm effectively from the cooling
effects of surgery and anesthesia. If they're not shivering, which increases their
oxygen needs, you won't see desaturation during their recoveries and can avoid
intervening. In outpatient surgery, where time- and cost-efficiencies are in
demand, the value of faster awakenings and faster discharges is clear. OSM
Dr. Lawson (
g a swa rrior@hotma il.com
) is an anesthesiologist at the Adult &
Children's Surgery Center of Southwest Florida in Fort Myers, Fla.
P A T I E N T M A N A G E M E N T
OUNCE
OF
PREVENTION
Maintaining
perioper-
ative
normothermia
can
prevent
the
need
for
post-op
interventions.
Pamela
Bevelhymer,
RN,
BSN
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