ing officer of Surgery Direct, an ASC development firm based in
Dallas, Texas, says it's not uncommon for nurses and techs to "pile on
5 or 6 blankets" — each one bearing a reprocessing cost of about $5
— trying to keep the patient's core temperature from dropping. In
comparison, some vendors of forced-air warming systems provide the
warming units at no cost on the condition that the facility agrees to
purchase a set number of the accompanying disposables from them.
For virtually every case, Ms. Kirchner advocates the use of an upper-
body or lower-body forced-air warming blanket. "We don't have any-
thing to lose, and in some instances patients have a lot to gain," she
says. "You're keeping patients comfortable versus having them shiver
and being exposed to a situation that could cause a post-op problem."
Besides the mode of warming, there's also the critical issue of tim-
ing, as in when you start the warming process. Some facilities do so
only after surgeries run a certain length — longer than an hour, say —
A U G U S T 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 6 3
irrigation fluids — they "pale in comparison" to anesthesia, says
Dr. Steelman.
Unless you start warming before the induction of anesthesia, at
which point the heat shifts from the core to the periphery, the
body temperature will drop too quickly to keep up. "If you don't
prevent that from occurring," says Dr. Steelman, "you're going to
be fighting it from the start of the procedure."
• Myth No. 4: "I can just turn up the room temperature." Say
an OR has an ambient temperature of 70º F at the start of a case.
The human body has a normal core temperature of 98.6º F.
That's a spread of 28.6º F. "Even if you turn the OR temperature
up to 80º F, which would never happen because it would be too
uncomfortable for the surgeons, it's still too low to prevent
hypothermia," she says. — Bill Donahue