Despite the increasing studies on perioperative hypothermia and the need to pre-warm patients, inadvertent perioperative hypothermia continues to be a problem in surgical settings.
There is little argument amongst scholars and medical professionals that pre-warming should occur, however, NICE guidelines have not been updated since 2016, and do not take into account innovations that have come to market since.
This lack of cohesion, combined with the absence of knowledge and training in patient warming, culminates in some patients developing hypothermia before, during, or after surgery.
An American study found that “even with modern supportive care, hospital mortality of patients with moderate or severe accidental hypothermia approaches 40%.” In most cases, perioperative hypothermia is preventable. [1]
We have compiled 5 of the most significant reasons to implement a solid patient warming strategy.
Patient comfort
At the centre of this is of course, the patient. Not only does pre-warming offer better surgical outcomes, and a reduced chance of developing unpleasant complications, it also provides an overall better experience for the patient.
An article by AORN explains that perioperative warming can prevent a patient’s discomfort, decrease their anxiety, and generally make them feel more at ease and prepared for the surgery ahead. Additionally, the article describes how “patients fall asleep faster when they’re warm”. [2]
All methods of pre-warming increase patient comfort, however, an article by the Journal of PeriAnaesthesia Nursing, they found that older participants in the study responded better to passive warming measures, due to their increased temperature.
Pre-warming a patient with a passive warming blanket improves comfort as it remains with them throughout their journey. Transfer between locations is another opportunity for patients to lose heat, with active warming solutions, the patient may arrive into the operating room cold. Comparatively, passive warming blankets are applied around 30 minutes prior to surgery, keeping the patient warm and comfortable throughout.
Reduced complications
Multiple studies have shown that inadvertent perioperative hypothermia can lead to a variety of complications for the patient, such as cardiac arrhythmias, increased mortality, infections, prolonged bleeding, complications of surgical wounds and increased shivering.
According to an article by the Journal of Perioperative Nursing, around 70% of surgical patients will experience inadvertent perioperative hypothermia. For a preventable issue, this number is far too high. [4]
Depending on the patients health and age, the consequences of developing hypothermia at this time may range from mild to severe.
Furthermore, pre-warming a patient and avoiding hypothermia before, during, and after surgery reduces the length of post-op stays, improving the patient’s comfort and satisfaction, as well as their recovery process.
If a patient develops hypothermia, and is constantly shivering, they will be consuming more oxygen, and potentially more pain medication, delaying their discharge. [2]
Cost efficient
As previously discussed, pre-warming a patient prior to surgery reduces their risk of further complications and can shorten their post-operative stay in hospital. In turn, this reduces the resources patients will use, in terms of a hospital bed, food, medication, patient wear and more.
In terms of patient warming, there are further savings to be made for hospitals. Passive warming blankets are a cost-effective choice for pre-warming, especially when compared to active warming options such as Forced Air Warming.
In one study, passive warming measures were found to be less expensive than their forced-air counterparts. Savings of around >7$ per patient were discovered (around £5.52 GBP). When we consider the volume of patients undergoing surgery in any given year, this could be a significant saving, especially for public health systems.
The associated costs of perioperative hypothermia is not just a challenge in the UK. The journal article “Costs of inadvertent perioperative hypothermia in Australia: A cost-of-illness study” tells us that the estimated annual cost of inadvertent perioperative hypothermia to the Australian Health System is around $1,259,725,856. This is a significant cost that could be better spend in other areas, especially as perioperative hypothermia is a preventable condition.
Improves surgical outcomes
We know that surgery comes with various risks, therefore, reducing as many risks as possible is key to improving the patient’s outcome. A combination of the anaesthesia used, patient health, temperature of the pre-op room, as well as the operating room, and other factors can cause a patient to develop hypothermia during surgery. [5]
Typically, hypothermia will develop within the first hour of surgery, usually after the introduction of the anaesthetic. This poses a particular problem for those in long surgical procedures, where risks are even greater. Developing hypothermia during this time may cause a decreased ability to fight infection, which can be common hospital environments.
One study found that the core temperature of patients who were not pre-warmed declined more than those who did receive pre-warming, despite active warming during the procedure. [1]
An ageing population makes surgical procedures more challenging. With operations for things such as hip fractures from falls, elderly people are more at risk of developing complications. This is why making every effort to avoid unnecessary risk is crucial, and pre-warming patients before surgery is a simple yet effective method of avoiding perioperative hypothermia.
Saves resources and reduces waiting times
Currently, in the UK, hospital beds are a precious commodity. Post-COVID, waiting lists for surgery are beginning to make a return to normal, but waiting times are still extensive. Pre-warming patients before surgery has been shown to be cost-effective and save on hospital resources.
Complications related to inadvertent perioperative hypothermia include things such as surgical site infections, cardiac issues, increased transfusion needs and more, all of which come at a cost.
Pre-warmed patients tend to have shorter recovery times, and in turn, shorter post-op stays. This allows their bed to be used for another patient, improving the flow of waiting lists for surgical procedures.
Not only that, a patient who recovers faster uses less energy, food, medication, patient wear, linens and time from medical professionals.
Pre-warming patients improves efficiency, saves time, money, energy, and improves the patients experience and medical outcome.
Passive warming blankets for pre-warming patients
There are variety of warming methods, each with their own benefits and drawbacks. However, passive warming blankets offer a cost-effective, space saving, and simple solution that patients are comfortable with.
Forced air warming systems have been used in hospitals for decades and have been proven to have positive outcomes. However, these systems are more expensive and difficult to use when compared to passive warming. While FAW systems may be the right solution for longer surgeries, they require additional equipment to work, at further cost to the facility. In addition, there are concerns that FAW may pose a risk of surgical site contamination. [4]
Typically, active warming solutions require a lot of space, and a significant upfront investment. This is not possible for many hospitals and operating theatres.
Cotton blankets may be provided pre and post operatively for patients, however, the heat from pre-warmed cotton blankets dissipated within ten minutes. In order to keep a patient warm in this way, a large number of blankets would be needed. This is not time or cost efficient. [4]
Comparatively, passive warming blankets act as an insulator, and reduce the heat loss from the patient’s body. It has been proven to be significantly more efficient and effective than using cotton or polycotton blankets. In addition, a passive warming blanket can remain with the patient throughout their surgical pathway, increasing their comfort and making efficient use of resources.
However, not all passive warming solutions are created equal. There are many varieties of “foil blankets” available, not all of which are suitable for medical procedures. A traditional foil blanket would not provide the sufficient amount of insulation needed for surgeries.
It is vital to trial the efficacy of passive warming products before deciding which to choose. THERMARMOUR has been thoroughly tested by clinicians and independent experts who have confirmed its effectiveness at maintaining normothermia in a perioperative setting. Read more clinical evidence.
You can now request our buyers guide. Filled with useful information to help you choose the right passive warming products.
Sources
[1] https://www.sciencedirect.com/science/article/pii/S2049080121010098
[2] https://www.aorn.org/outpatient-surgery/article/2021-May-patient-warming-benefits
[3] https://www.sciencedirect.com/science/article/abs/pii/S1089947221002094
[4] https://www.journal.acorn.org.au/cgi/viewcontent.cgi?article=1025&context=jpn
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10026532/
[6] https://www.sciencedirect.com/science/article/abs/pii/S1322769619301891
Categories: Medical
Tags: hypothermia, hypothermia prevention, medical, perioperative hypothermia, surgery, surgical
