We use warm cloth blankets for pre-op and forced-air warming blankets for the OR and, for some patients, in PACU as well. Cataract and pain management patients are in the OR for such a short time that they rarely need active warming, and cloth blankets generally suffice throughout the process. Here are 6 factors to consider when shopping for patient warming equipment.

Convenience. Ease of use is critical. You want something that's essentially plug and play, easy to assemble and easy to move from place to place.

Access. Consider how much access different warming methods offer, and whether they'll work around a surgical site's demands. For example, orthopedic procedures can leave an operative extremity uncovered by a blanket, while laparoscopic and abdominal procedures may be better served by warmed fluids or underbody warming.

Footprint. How much space, care and handling does the equipment require? A blanket warming cabinet, for example, needs floor space. If you want to go the reusable warming pads route, you'll have to clean them between each patient use.

Case mix. Your case mix will dictate how many of each warming device you'll need to purchase. If your surgeons bring a lot of cases that are at least an hour long, it's advisable to have one device for each OR (unless of course you opt for a blanket warmer). If you deal primarily in quick, short cases, you can probably get by with fewer, or different methods throughout the perioperative process.

Product trial. Trial and compare different warming devices. We asked 3 manufacturers of forced-air warming systems to bring their units to our center with 12 of the disposable blankets each. Then we used them on 36 patients undergoing the same type of surgery, measuring their core temperatures pre-, intra- and post-operatively. Our nursing staff recorded these temperatures, along with their comments on the use of the equipment, on evaluation forms.

Cost of disposables. As it turned out, there was no substantial clinical difference between the 3 warming products we trialed. Patients' core temperatures averaged out the same. One warming unit was more compact, though, and in the end our purchasing decision came down to the best price on the single-use blankets, which are, after all, going to be warming's continuing cost on our budget. Some manufacturers even offer the forced-air units without cost in exchange for an agreement to purchase a specified amount of the disposables. I'd asked each manufacturer for their best offer on the disposables — sometimes it's better to go direct to the source — but ended up securing the best deal by asking for our group purchasing organization's prices on each.

Arizant Healthcare, a 3M company
3M Bair Paws Pediatric Warming Gown
(800) 733-7775
www.bairpaws.com
List price: not disclosed
FYI: The 3M Bair Paws system now offers a pediatric gown to warm and comfort the smallest surgical patients. The dual air-channel inserts and hose ports are compatible with the Bair Paws 800 series warming unit for pre-warming and comfort warming as well as with the 500 to 700 series temperature management units. The pediatric gown, made from soft material, accommodates children over 40 inches tall and is designed to be used in the pre-op, PACU and through select surgical procedures. Refastenable strips offer quick access to the arms and chest, while side ties ensure full coverage.

Augustine Temperature Management
HotDog Underbody Warming Mattress
(888) HD-WARMS
www.hotdog-usa.com
List price: about $1,600 for purchase, or $85 per month for Patient Warming Service program
FYI: HotDog's Underbody Warming Mattress rests on top of existing OR table pads, providing unrestricted access to the patient. The flexible, conductive fabric — available in 19.5-inch by 32-inch or 50-inch sizes — conforms to the patient for safe and effective warming without blowing air, stiffness or the risk of leaking water. The company notes that recent research found a reduction in deep-joint infection rates after clinicians switched from forced-air warming to conductive warming products.

Encompass Medical
Thermoflect Patient Care Products
(800) 284-4540
www.thermoflect.com
List price: $1 to $7 per item distributor cost, with discounts for national contracts
FYI: Thermoflect blankets, caps and patient gowns (in adult and pediatric sizes) effectively and safely maintain patient warmth using science instead of electricity. The lightweight, lined material reflects patients' own radiant heat and prevents convective heat loss. The garments are an effective standalone warming solution for cases up to 1 hour and can supplement mechanical warming methods for longer cases.

Enthermics Medical Systems
ivNow Fluid Warmers
(800) TO-B-WARM
www.ivnow.com
List price: $1,459
FYI: Enthermics' ivNow fluid warmers, also distributed by Pedigo (www.pedigo-usa.com), can heat intravenous and irrigation fluids to 40 ?C in 30 minutes or less. They constantly monitor and precisely maintain fluid temperatures. The "open cradle" design — a contoured warming surface that fits 1-liter solution bags — makes placing and retrieving the bags easy. A smart control turns on when a bag is in the warmer and turns off when it is removed. The warmers, which can be mounted on walls, countertops and mobile stands, are available in 1-, 3- and 5-cradle units.

Kimberly-Clark Health Care
Patient Warming System
(800) KC-HELPS
www.kchealthcare.com/warming
List price: warming unit, $8,925; single-use pads, $100 to $415 each
FYI: Kimberly-Clark's Patient Warming System is powerful enough to regulate body temperature and maintain normothermia during lengthy, complex procedures, yet simple and effective enough for ambulatory cases. A compact, portable control unit circulates heated water through non-slip, hydrogel thermal pads placed on the patient's body to conduct heat through the skin. The single-use pads are available in a range of sizes to fit nearly all body surfaces.

Lexion Medical
Insuflow
(877) 9-LEXION
www.lexionmedical.com
List price: not disclosed
FYI: An accessory to any insufflator, the Insuflow laparoscopic gas conditioning device can simultaneously warm CO2 gas to 95 ?F and humidify it to 95% relative humidity. This consistent conditioning has been scientifically proven to benefit patient outcomes by maintaining the integrity of the peritoneum and the patient's core body temperature to prevent intra-operative hypothermia and decrease the risk of post-op pain.

MAC Medical
Blanket and Fluid Warming Cabinets
(877) 828-9975
www.macmedical.com
List price: $3,900 to $9,500
FYI: MAC Medical's blanket and fluid warming cabinets are available in a range of custom-built sizes, from small, countertop units to standalone single-, double- and triple-chambered units (the multiple-chambered units come with independent temperature controls for each chamber), and feature a variety of additional options to meet any facility's clinical requirements, such as stainless steel or glass doors, internal data logging, temperature lock-outs and locking doors.

Medivance
Arctic Sun 5000
(877) 267-2314
www.medivance.com
List price: $49,000
FYI: The touchscreen interface and built-in training module on Medivance's Arctic Sun 5000 warming unit make it simple to program for fast and safe core temperature management. Used in conjunction with Arctic Gel pads, which transfer thermal energy through conductive warming, the system delivers precise, accurate, reproducible results for all patients in any clinical setting.

Microtek Medical, a division of Ecolab Healthcare
ChillBuster Portable Patient Warming Blanket
(800) 352-5326
www.microtekmed.com
List price: averaging $8 to $10 per patient
FYI: Anywhere that warm blankets are used, ChillBuster electric warming blankets can serve to stabilize patients' body temperatures for comfort and hypothermia prevention. The compact, silent and mobile heating unit runs on electrical power or a rechargeable, 4-hour battery and features adjustable temperature settings that quickly reach up to 105 ?F. The electric blanket's reuse is easily facilitated with single-use blanket covers, available in sterile and non-sterile packaging.

NovaMed USA
Koala Warming System
(800) 425-3535
www.novamed-usa.com
List price: $5,995
FYI: Looking for a green patient warming solution? The reusable, underbody warming mattress is designed to be strapped over a stretcher or OR table's existing surface. It incorporates conductive carbon polymer technology for safe and uniform warmth and memory foam for comfort. A simple and silent control device regulates the mattress's temperature.

Stryker Medical
Thermacare Patient Warming System
(800) 869-0770
www.stryker.com
List price: $1,995
FYI: Stryker's Thermacare system provides effective, convective patient warming through a lightweight, portable, warm-air blower unit. The system offers a range of temperature settings with convenient, automated operation. The unit's flexible hose is covered to enable thorough, easy cleaning, while a secure hook-and-loop hose attachment minimizes accidental detachment from the single-use warming blanket. A variety of blanket sizes fit the needs of various specialties and case types.

Scientek Technology Corporation
SWC-015-041 Dual Chamber Warming Cabinet
(866) 321-3828
www.scientek.net
List price: $7,560
FYI: Warming cabinets are designed to elevate the temperatures of fluids or blankets. Scientek's dual-chambered SWC 015-041 can do both. Each chamber has independent digital controls to maintain constant, separate and pre-set temperatures. Its stainless steel construction contains insulated double walls and adjustable shelves, and its gasketed doors are available with glass fronts for counting inventory at a glance.