Hypothermia in trauma patients is a real concern, no matter the type of trauma. Hip fractures are a painful and frightening incident for the patient. In the 2020/21 period, 56,590 hip fractures occurred in those aged 65 and over in England. Although hip fractures UK wide across all age groups are thought to exceed 76,000. As the treatment requires surgery, there a multitude of influencing factors to the surgery’s success.
We take a look at the implications of patient warming and hypothermia on hip fracture surgeries.
The hypothermia problem
Surgery to rectify a hip fracture comes with various risks, one of the most prominent risks being hypothermia – particularly in the perioperative period. A patient experiencing hypothermia at the perioperative stage is at further risk of infections, and unfortunately even increased mortality. The various stages between the patient being responded to, and the post-surgery recovery, provide opportunities for hypothermia to develop.
The combination of an ageing population, and the severity of a hip fracture are contributing factors to the need for better hypothermia prevention methods to be used in surgery.
Perioperative hypothermia and hip fracture studies
To determine the effect of perioperative hypothermia during hip fracture surgery, Gurunathan et al conducted a prospective cohort study. Mapping the patients’ journey from the ward to holding bay, to theatre, and finally to the post anaesthetic care unit (PACU). To measure the temperatures during this journey, tympanic thermometers were used to record the temperatures in the rooms.
- A 0.7°C decrease in temperatures between the holding bay and arriving in the PACU.
- A 0.2°C decrease between the holding bay and the first recorded temperature of the operating room
- Ambient temperatures remain consistent throughout journey
- Around 30% of patients entered the PACU hypothermic
- 8% of 87 participants arrived at the operating room hypothermic
For the 8% of patients, staff used existing practices to maintain normothermia, which comprises of two cotton blankets in the waiting area. The findings indicate that patients are potentially losing heat via the journey from ward to operating room, contributing to the hypothermic arrival of patients to surgery.
Preventing perioperative hypothermia
A study by Williams et al, of 929 hip fracture patients found that patient inadvertent perioperative hypothermia was linked to higher 30-day mortality rates. As well as higher 30-day re-admission rates. Furthermore, the study concludes that patients who arrive to theatre hypothermic are almost twice as likely to by hypothermic when leaving the operating room too.
This illustrates just how vital it is to put processes and or products in place to reduce the risks of perioperative hypothermia and improve patient outcomes. This is where patient warming from THERMARMOUR comes in.
Thermarmour warming blankets are created to be used for the whole patient pathway to maintain normothermia. They are a cost-effective patient warming device suitable for a range of emergency and medical situations. The six-layer lamination can be tailored and cut without compromising integrity. The warming blankets are also X-ray compatible, latex free and easy to store.
How to use for surgery
To mitigate the risk of hypothermia, the Ambulance Service should begin the warming process when they attend the scene and identify the patient in need. Continuing the use of the blanket throughout the journey to A&E. The blanket can be easily cut to suit the specific patient.
For elective surgery patients, patients should be pre-warmed by using a blanket for 30 minutes before anaesthesia is administered. The blanket will follow the patient during the following stages:
- Transport from ward to anaesthetic room
- During the procedure
- Transport to recovery (PACU)
- Transport back to the ward
This reduces the risk in each step of the patient journey, improving their chances of a successful recovery. Preventing hypothermia in trauma patients is easier with Thermarmour products.
The link between hypothermia and patient outcomes has been established in multiple research journals, including the one highlighted here. It has been found that pre-operative warming and active warming can help to protect against inadvertent hypothermia. Both can be achieved using the THERMARMOUR warming blanket. Hypothermia in trauma patients can be avoided, and needs to be a priority.
As the blanket is shrink-wrapped and easy to store, it is easily transportable and is effective in protecting the patient from hypothermia at all stages. An essential item for any emergency kit, or surgery room.