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Hypothermia - 2 Rewarming patients

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VOL: 97, ISSUE: 08, PAGE NO: 45

PHIL JEVON, RESUSCITATION TRAINING OFFICER, MANOR HOSPITAL, WALSALL

MATTHEW KELLY, PROFESSIONAL DEVELOPMENT NURSE, ITU;BEVERLEY EWENS, CONSULTANT NURSE, ITU, MANOR HOSPITAL, WALSALL

The management of hypothermia depends on its degree of severity. Passive and active rewarming methods are available. This Part describes passive rewarming and active external rewarming using a warm-air blanket. With profound hypothermia, more invasive methods, including inhalation of warmed humidified gases and administration of warmed intravenous fluids, may be used (see Nursing Times, March 1).

The management of hypothermia depends on its degree of severity. Passive and active rewarming methods are available. This Part describes passive rewarming and active external rewarming using a warm-air blanket. With profound hypothermia, more invasive methods, including inhalation of warmed humidified gases and administration of warmed intravenous fluids, may be used (see Nursing Times, March 1).

A warm-air blanket is an effective method of rewarming a patient. It can be used in a variety of clinical settings, but is most commonly used postoperatively. However, it is potentially hazardous and the user must refer to the manufacturer's instructions before using this method of rewarming.

There is a potential explosion hazard with warm-air blankets, and they should not be used near flammable anaesthetics. In addition, contact between the blanket and equipment including lasers or electrosurgical active electrodes should be avoided.

The manufacturers advise that the blanket should not be applied over open wounds or ischaemic limbs. If the patient has peripheral vascular disease, a warm-air blanket must be used with caution and the limbs should be closely monitored.

It is most important to monitor the patient's vital signs while using this warming system. If the patient becomes hypotensive during its use owing to vasodilation, either reduce the air temperature or switch off the warming unit and seek medical advice.

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