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Cutting surgery hypothermia risk

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Latest NICE guidance backs theatre nurses’ calls for more resources to help prevent surgical patients developing hypothermia, say specialists.

The institute last week published guidelines on preventing hypothermia in patients undergoing surgery.

The guidance warns that inadvertent hypothermia is common during surgery. Having a core body temperature of under 36°C occurs in 70% of unwarmed patients on admission to the recovery room, which can lead to complications, NICE said.

The guideline recommends that staff should provide at least one cotton sheet and two blankets or a duvet if patients are cold prior to operations. Staff should assess patients for hypothermia before they are taken to theatre and, if they are hypothermic, forced warm air should be used to warm them.

Additionally, the patient’s temperature should be recorded before anaesthetic and for every 30 minutes until the end of surgery. After surgery their temperature should be recorded on admission to the recovery room and every 15 minutes.

Susan Pirie, professional officer for the Association for Perioperative Practice, said that while most anaesthetic, surgical and recovery staff did comply with much of the guidance already, there was variation in practice.

‘Some units may have been fighting to get to do this and now have the clout to do it,’ she said. ‘Saying, “NICE guidance says we need to do this” can be a powerful tool.’
The guidance will standardise care and help staff to argue for more resources if there is a shortage, she said.

Many units bought warming devices some time ago but with the increase in throughput of patients having surgery, some will not currently have sufficient numbers, Ms Pirie warned.

Off-site laundry facilities at most hospitals means there can be a time delay in receiving the sheets, blankets and duvets back, so this could also be a problem in some places, she added.

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