Warming patients before, during and after surgeries delivers two primary benefits. The most obvious is the comfort. Warmth can do wonders to soothe a shivering, nervous patient. But the second benefit, patient safety, often doesn’t get the credit it deserves. Warming patients throughout their perioperative episodes maintains normothermia, which can prevent surgical site infections (SSIs) by promoting better healing of their surgical wounds.
Mimi DesBiens, BSN, RN, administrator and director of nursing at Premier Outpatient Surgery Center in Colton, Calif., says her facility began actively warming patients in the mid-2010s. “We did warm patients before that, but mainly with warmed blankets,” she says. Then a director of nursing from Loma Linda University arrived at her facility, and brought the active warming with her.
The practice took hold, and now active warming is a core tenet of patient safety at Premier. In fact, the primary reason patients are warmed is to prevent SSIs. “It’s an evidence-based practice for infection control,” says Ms. DesBiens. “If you keep the patient warm enough, you have good blood flow to the incision site, and it helps with healing.” Another impact of warming has been quicker recoveries with reduced postoperative usage of narcotics. “We don’t want that risk of hypothermia,” she says. “Before we started using warming devices, some patients came into the PACU shivering, and we had to use quite a bit of narcotic medications,” she says.
Ms. DesBiens’ facility has criteria that triggers the implementation of its active warming protocols. “For the most part, active warming is always going to be used when the patient’s body is exposed and under general anesthesia using inhalational agents for procedures that last longer than 30 minutes,” she says. The practice is regularly deployed with longer cases involving MAC sedation as well — but not for shorter procedures. “If it’s a quick 30-minute carpal tunnel case under MAC sedation, we’ll give them warm blankets,” she says.
The exception to this is age. If an 80-year-old patient who is cold to begin with comes into pre-op, there’s a very good chance active warming will take place, says Ms. DesBiens. “We do a lot of nursing assessment when it comes to warming, and if the anesthesia provider requests it, we do it,” she adds.