Here are a few ways to constantly monitor body temperature so that your patients keep warm from pre- to post-op.

1. Infrared scanning device

Your journey to keeping your patients normothermic starts when they walk through those surgical facility doors. For Kim York, BSN, MS, RN, CNOR, CSSM, that means turning to the temporal infrared scanning device, a small, handheld thermometer with a round plastic tip that you press and hold against the patient's forehead before scanning it across her skin. The device captures infrared heat emitting from your patient's skin and measures it against the temperature of the surrounding area. It uses both measurements to determine arterial heat temperature, which is close to core body temperature. That temperature is shown on a screen on the device, either in Fahrenheit or Celsius.

"It gives us a baseline," says Ms. York, the director of surgery at Dosher Memorial Hospital in Southport, N.C. She adds that her hospital uses the thermometer to check patients' body temperatures as soon as they enter the facility to see what they'll need to do to keep them normothermic. Anyone with a temperature over 36 ?C (normothermic) will likely require only warm blankets, while anyone with a temperature under 36 ?C will require more effort to raise their temperature before surgery.

The device is widely used, both in surgical centers and at home by patients. A simple, at-home device can cost around $40, while others that are meant for more accurate readings in medical facilities can be purchased from medical supply companies for up to $400. The device is easy to use and simple, says Ms. York. It's less invasive than an oral or rectal measuring system, for which her patients no doubt are grateful.

2. Skin dots

If you're looking for a less invasive way to monitor core temperature, Daniel Sessler, MD, chair of the department of outcomes research at the Cleveland (Ohio) Clinic, suggests a circular insulated patch, around 1 inch in diameter, which you affix to the patient's forehead. The patch insulates the skin directly underneath it so that the section of skin isn't losing any heat to the surrounding environment.

"What you've created is a perfect insulator," says Dr. Sessler. That insulation creates an isothermal pathway, which, within about 5 minutes, allows the heat from the deep tissue underneath the patch to rise to the surface, where the patch catches and records it. That gives you an accurate core temperature reading without having to make the patient undergo an invasive reading.

The patch is affixed via wires to a small nearby system — around 6 inches across — which displays core temperature readings for as long as patients wear the device, says Dr. Sessler. The patches are single-use only and cost around $5 per patch.

The technology is still relatively new, but it's got an advantage because of how non-invasive it is and how it stays with the patient into the post-op period.

3. Sticker monitoring

Stickers that determine a patient's temperature are becoming more popular, especially for the intraoperative period, when the OR temperatures and anesthesia can make a patient's temperature plummet, says Ms. York. Her facility uses a temperature indication sticker during surgery. The sticker has an image of a traditional thermometer, with a row of Fahrenheit temperatures on one end (84 ?-106 ?) and a row of Celsius temperatures on the other (29 ?-41 ?). When the sticker is affixed to the patient's forehead, a bar between the 2 rows will move up and down, depending on the body temperature of the patient, says Ms. York.

That can be a great indicator during surgery because it has no attachments and doesn't interfere with a procedure, but it can still indicate to nurses and anesthesia providers when a patient is losing body heat.

Case by case

Every normothermia case is different and should be treated as such. Consider the fact that core temperatures are generally slightly higher in women than men and that they vary by about 1 ?C, according to Dr. Sessler. Or what about the study that shows elderly patients are more prone to becoming hypothermic during surgery? By supplying your facility with a variety of tools to manage and monitor normothermia, you're ensuring that you can approach each patient's case with the individualized care it needs. OSM