AORN journal
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Randomized Controlled Trial
Effect of preoperative forced-air warming on postoperative temperature and postanesthesia care unit length of stay.
Unintended hypothermia in the surgical patient has been linked to numerous postoperative complications, including increased risk for surgical site infection, increased oxygen demands, and altered medication metabolism. The lack of literature on the subject was part of the impetus for perioperative nurses in one hospital to conduct a quality improvement project to evaluate the effectiveness of preoperative warming on patients' postoperative temperatures. We randomly assigned 128 patients to either a group that received a forced-air warming blanket preoperatively or a group that did not. Our results showed that prewarming patients before surgery did not have an effect on patients' postoperative temperatures.
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Comparative Study
A comparison of warming interventions on the temperatures of inpatients undergoing colorectal surgery.
This study compared the effects of two different warming interventions in the preoperative setting on the preoperative, intraoperative, and postoperative temperatures of patients undergoing colorectal surgery in an inpatient setting. The study was performed to determine whether prewarming patients for at least 30 minutes would result in postoperative temperatures of 36° C (96.8° F) or higher within 15 minutes of their arrival in the postanesthesia care unit. ⋯ One reason may be that all the patients were warmed with a forced-air warming device before induction in the OR. Our study does not recommend a specific intervention for a prewarming strategy but indicates that prewarming may contribute to normothermia in the immediate postoperative period.
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A malignant hyperthermia (MH) crisis is a medical emergency. To give the patient the best possible chance for a successful outcome, a swift, coordinated, multidisciplinary team response is necessary. ⋯ An MH response plan should be developed to guide a multidisciplinary team during an MH crisis. This plan should be tailored to the needs of the individual health care organization and practiced and refined during periodic simulations of MH episodes, such as MH mock drills.
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Maintaining perioperative normothermia is important to ensure that a patient does not experience inadvertent hypothermia and its consequences, such as increased blood loss, cardiac abnormalities, prolonged recovery, and increased risk for wound infection. Many clinical guidelines recommend the use of forced-air warming as one of several techniques to prevent inadvertent perioperative hypothermia. Safe use of forced-air warming devices includes choosing the right device, assessing the patient for risks, protecting the patient from burn injuries, appropriately maintaining the patient's body temperature, and using the device as directed by the manufacturer's recommendations. Staff members should receive education on hypothermia and warming technology on a regular basis.