Outpatient Surgery Magazine

Manager's Guide to Ambulatory Anesthesia - July 2014

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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2 7 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 SS_1407_Layout 1 7/1/14 2:24 PM Page 27

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