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New NICE guidance on surgical temperature taking

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Some common techniques for taking temperature must not be used before, during or after surgery, states new official guidance on preventing hypothermia on the operating table.

The guidelines issued today by the National Institute for Health and Care Excellence stresses the importance of accurately assessing adults’ core temperature just before they go under the knife and during procedures.

“Keeping patients warm before, during and after surgery is essential”

Mark Baker

This means some methods familiar to nurses such as infrared ear thermometers and forehead strips should not be used, says the guidance.

Only techniques that provide a direct measure or accurate estimate of core temperature should be deployed, it states.

These includes traditional techniques such as a thermometer under the tongue or armpit or in the rectum alongside more sophisticated technology to measure temperature via pulmonary artery and urinary catheters, or distal oesophagus or deep forehead techniques.

Hypothermia – when body temperature drops below 36 degrees – during surgery can lead to a patient losing more blood, increase the risk of heart problems and slow down healing.

“The method used to take a patient’s temperature before surgery is important, with methods that measure core temperature of the blood or organs being most accurate,” said Professor Mark Baker, director for the centre of guidelines at NICE.

Under the tongue measurements are also fine for patients with near-normal temperatures,” he noted.

The guidance also recommends all adults having surgery – not just those at higher risk of hypothermia – should be given help to stay warm before their operation.

Ideally, active warming for all patients should start at least half an hour before an anaesthetic is given unless emergency surgery is required.

Hospital staff should pay particular attention to the comfort of people with communication difficulties, such as those with learning disabilities, before during and after surgery, the guidance adds.

Mark Baker

Mark Baker

Mark Baker

“Keeping patients warm before, during and after surgery is essential for helping reduce clinical problems such as increased blood loss, longer recovery and delayed healing,” said Professor Baker, who hoped the updated guidance would help improve outcomes.

“This updated guideline also underlines the importance of hospital staff ensuring all patients are kept warm at all stages of surgery – not only patients at higher risk of hypothermia,” he said.

He added that patients, families and carers should be told about the importance of staying warm before surgery and encouraged to tell staff if they or a loved-one feels cold.

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