Maintaining perioperative normothermia is the main goal of patient warming. Hypothermia has real consequences for surgical outcomes. But don't discount the real selling point of warming: happy patients. Even if they're wrong about everything else, patients are always right about the temperature. It is cold in here!

Many methods
Between convective (forced-air) warmers, table pads, blanket cabinets, heated fluids and other methods, you've got a lot of options to assist you in keeping your patients between 36 ?C and 38 ?C. To decide which are most suited for your patients and facility, ask yourself:

• What procedures are we doing? Although pre- and post-op patients can be completely covered, warming in the OR must be balanced against the need for surgical access. Some cases require exposure or positioning that may make particular warming methods cumbersome or intrusive.
• How effective is it? You don't have to wait for the next published study. During a product trial, demonstrate a method's results on your patient throughput. Monitor and record patients' temperatures in pre-op, the OR and PACU. As an added bonus, this could be the basis for a good QI study.
• What's the cost? Compare the costs of all the components or factors in warming processes, whether they're units and disposables or time and reprocessing, as well as how long the end result keeps a patient warm. This may demand asking how much patient satisfaction is worth to you and your surgeons. We warm nearly every patient, from pre-op to discharge, with forced-air warmers. (Our pain management patients get warmed blankets because their cases are so short and they're not anesthetized.) At $25 to $30 each, the disposable gowns are a real expense. We could conceivably spend less on warming, but our surgeons are committed to convective warming and patient comfort. They know we keep the ORs cold and they know how much patients appreciate warmth, and would rather not pinch pennies on that front. Still, don't take the first price the warming vendor offers. Work with your GPO and fight for a good deal.

3M
Bair Paws Flex Gown
bairpaws.com
(800) 733-7775
Pricing: not disclosed
FYI: 3M's Bair Paws Flex Gown combines the comfort and convenience of a Bair Paws gown with the proven warming ability of Bair Hugger upper- and lower-body blankets. Patients can arrive in the OR pre-warmed by the gown, then 2 separate inserts let you activate warming where you want it while gaining surgical access.

Covidien
WarmTouch Convective Warming System
covidien.com
(800) 635-5267
Pricing: not disclosed
FYI: The WarmTouch convective warming unit features an intuitive screen showing the temperature and status of each of its 5 thermal settings. The soft, tear-resistant WarmTouch blankets, designed for even airflow, are available in a range of sizes and types, including full body, upper body, lower body, cardiac, and pediatric, to accommodate all patients and procedures.

Augustine Temperature Management
HotDog Underbody Warming Mattress
hotdog-usa.com
(888) HD-WARMS
Pricing: about $1,600 for purchase, or $85 per month through 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 also produces flexible, conductive overbody electric blankets.

Medline Industries
PerfecTemp
medline.com
(800) MEDLINE
Pricing: $12,000 to $14,000, depending on configuration
FYI: Medline's PerfecTemp patient warming system combines sensored heating to maintain normothermia with the added benefit of pressure redistribution to minimize the risk of positioning and skin breakdown injuries. As a table mattress, it takes up virtually no additional space in the OR, and its control unit includes an automatic starting timer to eliminate lengthy setups.

NovaMed USA
Koala Warming System
novamed-usa.com
(800) 425-3535
Pricing: $6,400 for purchase, or $245 per month for consignment plan
FYI: The Koala Warming System, a conductive underbody warming pad, straps to the OR table to maintain normothermia while allowing unhindered patient access and providing pressure relief. Simple to use and completely reusable, it's available in a variety of sizes to fit different table models.

Pintler Medical
Patient Warming System
pintlermedical.com
(877) 620-9868
Pricing: $4,450 to $4,850, depending on volume
FYI: Pintler Medical's Patient Warming System delivers steady, uniformly distributed thermal comfort through a pressure reduction surface. The durable, seamless OR table pads won't harbor contaminants and are easily wiped clean. The silently running system requires no setup time, and is connected via a ribbon cable to a compact, fluid-resistant, IV-pole-mounted control unit.

Alleset Healthcare
Cozee
alleset.com
(866) 689-2707
Pricing: not disclosed
FYI: The Cozee line of passive patient warming blankets offers a more effective alternative to cotton blankets. Its 3-layer design provides a 20% higher thermal insulation value. As a single-use product, it reduces the risk of cross-contamination and eliminates laundering costs and time. The blankets are shrink-wrapped for compact storage and are available in several sizes and material options, including the biodegradable ECO2 blanket.

Encompass Group
Thermoflect Patient Warming Products
thermoflect.com
(800) 826-4490
Pricing: $1 to $7 per item distributor cost, with discounts on national contracts
FYI: Thermoflect blankets, patient gowns, bouffant caps, pediatric pajamas, and even staff apparel put a heat-reflective technology pioneered by NASA to use in preserving core body temperature and preventing convective heat loss (aka wind chill). The lightweight, durable and comfortable textiles require no electricity and no maintenance, and maintain normothermia throughout procedures, even those lasting less than an hour.

Ecolab
Fluid Warming Systems
ecolab.com/healthcare
(800) 824-3027
Pricing: not disclosed
FYI: Warming saline bottles in a cabinet outside the OR requires routine labeling and rotation, and once removed, the bottles quickly cool. But Ecolab's OR Solutions Fluid Warming System and IntraTemp Fluid Warming System (pictured) provide OR personnel with immediate access to warmed irrigation fluid at a controlled and verifiable temperature.

Enthermics Medical Systems
ivNow Fluid Warmer
ivnow.com
(800) 862-9276
Pricing: starting at $999
FYI: Enthermics' ivNow eliminates the set-up time and disposable expense of in-line fluid warming. Placing an IV bag into the cradle activates the warmer, which warms fluids to 40 ?C in less than 30 minutes. A range of installation options are available for the modular device, which can be configured with a 1- to 6-bag capacity.

MAC Medical
Blanket and Fluid Warming Cabinets
macmedical.com
877-828-9975
Pricing: $3,000 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 stand-alone single-, double- and triple-chambered units (the multiple-chambered units are equipped 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.

Pedigo Products
P-2010 Countertop Warmer
pedigo-usa.com
(800) 822-3501
Pricing: $5,956
FYI: Pedigo's countertop blanket warmer employs an array of electrothermal cables in the 2.3-cubic-foot chamber's sides and bottom to evenly circulate warmth, eliminating the need for fans, lint traps and other moving parts. The insulated, glass-windowed door latches magnetically to maintain chamber temperature and conserve heat. Easy-to-use controls ensure precise set-point temperatures.

Scientek Technology Corporation
Warming Cabinets
scientek.net
(866) 321-3828
Pricing: $3,500 to $12,000, depending on configuration and options
FYI: Scientek's blanket and fluid warming cabinets are available in a range of sizes; in single-door or pass-through configurations; and with single or independently controlled, dual chambers. Their stainless steel construction contains insulated double walls and adjustable shelves. The gasketed doors can be obtained with glass fronts.

Skytron
J2 Series Warming Cabinets
skytron.us
(800) 759-8766
Pricing: $4,200 to $9,000
FYI: Skytron's J2 Series cabinets for fluids and blankets are available in countertop or standalone models with tempered glass or stainless steel doors that hinge right or left. The cabinets feature fully insulated heating compartments with separate recirculating fans, adjustable stainless steel shelves, adjustable temperature ranges, lock-in temps, and audible and visual over-temp indicators for safety.

Steris
Amsco Warming Cabinets
steris.com
(800) 548-4873
Pricing: not disclosed
FYI: Steris' Amsco blanket and fluid warming cabinets feature LED readouts for temperature confirmation, adjustable shelves for flexible organization and durable materials for years of use. Premium options include digital data recording and keyless locking capabilities. A pass-through model for access inside and outside the OR is now available.

Surgmed Group
HugAire Mini Table-Top Warming Cabinet
surgmed.com
(800) 661-5432
Pricing: $2,595 to $2,998
FYI: The HugAire cabinet has a capacity of 2 cubic feet and a footprint that allows tabletop mounting. Its microprocessor-based thermostat and digital display enable accurate temperature control and its fans system ensures efficient air circulation and uniform heat distribution. Insulated walls, a high-temperature warning light and automatic shut-down facilitate safe use.

Lexion Medical
InsuFlow Synergy
lexionmedical.com
(877) 9-LEXION
Pricing: $95 to $105
FYI: Building on the Insuflow laparoscopic gas conditioning device, Lexion Medical's Insuflow Synergy incorporates the earlier device's CO2 warming and humidifying capabilities into a 5mm instrument port. The pink port delivers 95 ?F, 95% relative humidity CO2 into the pneumoperitoneum for less fog and less post-op pain and disperses gas from multi-directional vents for stability.