Convective or conductive? Below, above or around the patient? Before, during or after the procedure? Blankets or blowers? Covers or pads? Yes, there's no shortage of ways to maintain normothermia, but no matter the warming device you choose and use, they all share the same goal: to prevent hypothermia.
As you'll see in the thumbnail sketches of 12 warming products over the next few pages, today's devices warm the patient in very different ways. Some even do double duty, like the forced-air warmer that's also an OR table positioning drape and the pressure-reducing OR pad that also warms the patient.
Then there's our more traditional warming methods: blanket and fluid warming cabinets, forced-air warmers (air to surface) and conductive-fiber warming blankets (surface to surface). Employing them separately or in combination can optimize your efforts to maintain normothermia.
Among other things, keeping patients warm helps limit the risk of post-op infections, decreases bleeding and can lead to faster recoveries.
If we don't actively warm our patients, we worry about unintended hypothermia and complications like increased blood loss or cardiac events. That's why pre-warming in the holding area before going into the OR is important. The colder the periphery — the arms and legs — are to start, the more redistribution of heat from the core to the periphery will occur, resulting in a colder patient.
When patients undergo general anesthesia or major neuraxial anesthesia like a spinal or epidural, they experience arterial vessel dilation in the arms and legs, leading to a redistribution of heat from the thorax and abdomen to the body's periphery. Redistribution can lead to a rapid decrease in the patient's temperature — up to 2 ?C per hour. If you don't do anything to keep the patient warm, their temperature will quickly go from about 37 ?C to around 35 ?C during the first hour of surgery.
You also have a financial incentive to warm patients. Medicare's Merit-Based Incentive Payment System calls for measuring perioperative temperature management for patients who are under anesthesia for more than an hour. It requires you to use a method of active warming and also for at least one body temperature reading to be equal to or greater than 35.5 ?C or 95.9 ?F within 30 minutes before or 15 minutes after anesthesia end time. OSM
3M
Bair Hugger Underbody Blankets
bairhugger.com
800-228-3957
Price: Not disclosed
FYI: Bair Hugger Underbody Blankets warm the patient while providing full, unrestricted patient access. You can position the blankets on the procedure table before the patient arrives. An outer channel surrounds the patient, directing warmth to both the core and periphery. Comes in 25 different styles, for routine to complex cases.
Augustine Surgical
HotDog Patient Warming System
hotdogwarming.com
888-439-2767
Price: $279/month per OR for underbody and overbody with monthly warming plan
FYI: This system warms patients safely and effectively with conductive-fabric warming blankets and underbody mattresses. It's the only system that warms above and below the patient simultaneously. Compact controllers and advanced sensors deliver low-voltage electricity to the flexible, lightweight devices for uniform and precise heat.
BCG Medical
Opt-Shield Air
bcgmedical.com
800-801-8493
Price: Not disclosed
FYI: Opt-Shield is a do-it-all OR table positioning drape that secures, protects and warms patients with forced air. Designed for lithotomy/Trendelenburg position procedures, the ingenious drape connects to a forced-air warmer once you've positioned and secured the patient in steep Trendelenburg. Passive warming and insulation to the arms and legs minimize heat loss during surgery, says the company. Low-friction fabric aids in lateral transfer.
Blickman
Blanket and Solution Warming Cabinet
blickman.com
800-247-5070
Price: Not disclosed
FYI: This double-door cabinet warms blankets and solutions in 2 separately heated compartments. The temperature control is set via key and pass-code lockout and ensures that the temperature remains within plus or minus 1 ?F of the set point. It has self-closing, magnetic gasket, adjustable-tension doors and there is a no-set temperature restriction between compartments. Each cabinet unit comes standard with integrated casters for ease of mobility.
CSZ
WarmAir Convective Warming System
cszmedical.com
800-989-7373
Price: Not disclosed
FYI: With this warming system and the company's FilteredFlo blankets, all air is filtered twice before being distributed to the air blanket. The patented design of the blankets permits use of a lower velocity blower to supply the air, and the filtered air warming method helps minimize air currents in the operating room environment. The warming unit offers quiet operation and 4 levels of therapy.
It's compact, with a light frame and has high and low temperature alarms.
Enthermics
WarmSafe Combination Warmers
enthermics.com
800-862-9276
Price: Not disclosed
FYI: The combination fluid/blanket warming system features a patented heating system and air-mixing fan to ensure an accurate set-point temperature. The WarmSafe zone system with heated shelves ensures every blanket is safely and evenly warmed by adjusting temperature throughout the cabinet, says the company. The stainless steel cabinets come with casters that allow for easy transport.
Mac Medical
D-Series Warming Cabinets
macmedical.com
877-828-9975
Price: $4,000 to $10,000
FYI: These blanket and fluid warming cabinets provide independent, digitally controlled heating chambers that offer temperature and set-point displays. Data is recorded every 30 minutes and stored for 2 years. Comes in single, dual or triple chambers.
Medtronic
WarmTouch Convective Warming System
medtronic.com
800-869-0770
Price: Not disclosed
FYI: The WarmTouch convective warming unit has an intuitive screen showing the temperature and status of each of the 5 settings, including "ambient" and "boost." The unit is lightweight, making it easy to transport and attach to a cart, bedrail or IV pole. The onscreen filter expiration warning tells you when to maintain and service the unit.
Pintler Medical
Pintler Patient Warming Systems
pintlermedical.com
877-620-9868
Price: $5,000
FYI: An OR pad that offers warming and pressure reduction? Pintler Patient Warming Systems combine active patient warming and pressure redistribution into a single product. The system consists of a control unit that mounts easily to an IV pole, operating table rail or a table pad.
Smiths Medical
Convective Warmer & Snuggle Warm Blankets
smiths-medical.com
800-258-5361
Price: Not disclosed
FYI: This system includes a high-flow convective warmer with hose-end temperature control, a convective warming blanket and accessories. The warmer draws ambient-temperature heat through a HEPA air filter. The warmed air enters the blanket through a hose and is distributed throughout channels and perforations on the patient side of the blanket to disperse the warm air. A safety circuit provides an independent means to discontinue power to the heater.
Stryker
Mistral-Air Warming System
stryker.com
800-869-0770
Price: Not disclosed
FYI: A high-volume blower combines with the soft, non-woven material of the blankets to enable quiet and even warm-air delivery through diffusion technology. By eliminating jets of forced air, lofting is minimized and warm air remains on the patient. The system includes over- and under-temperature alarms and has a default blower start-up
temperature of 38 ?C.
Thermoflect
Heat Reflective Technology
thermoflect.com
800-826-4490
Price: $1 to $7 per product
FYI: These heat-reflective blankets use NASA-
pioneered science instead of electricity to warm. Applied pre-operatively, Thermoflect reflects a patient's endogenous radiant heat and banks it in the body's core to help prevent redistribution temperature drop, says the company. Thermoflect is also available in staff apparel to keep providers warm, too.
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