O C T O B E R 2 0 1 7 O U T P A T I E N TS U R G E R Y. N E T 4 1
ing action. General and regional anesthesia also shift the body's thermal energy
from the core to the periphery, which results in vasodilation and a drop in blood
pressure.
To maintain normothermic temperatures during surgery, make sure the ambi-
ent temperature in the OR is set within the AORN-recommended range of 68°F
to 75°F, especially during the initial half hour of the case, when patients are at
greatest risk of losing body heat. Upper- and lower-body forced-air warming
gowns and underbody radiant heat mattresses help keep patients warm, while
giving surgeons the access they need.
It's understandable that surgeons and surgical team members might prefer to
keep rooms cool for their personal comfort, but that self-interest can be a signif-
icant barrier to maintaining normothermia in exposed patients. To keep the sur-
gical team satisfied and your patients safe, consider investing in cooling vests,
which surgeons and team members can wear to remain comfortable while they
work in adequately warm ORs. CMS's Surgical Care Improvement Project for
Body Temperature Management (SCIP Inf-10) states that patients who undergo
procedures expected to last longer than 60 minutes should either be actively
warmed or have a body temperature greater than or equal to 36°C within 30
minutes before or 15 minutes after anesthesia end time. That's why it's impor-
tant to actively warm patients both in the OR and in the PACU, and to continual-
ly measure their temperature readings until you can document normothermia
has been achieved. At that time, warming techniques can be applied simply to
keep patients comfortable until discharge.
OSM
Ms. York (kimyork@dosher.org) is
director of surgery at Dosher Memorial
Hospital in Southport, N.C.
