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    Heated Hospital Gown Reduces Risk of Surgical Hypothermia

    By Jennifer Decker Arevalo, MA, contributor.  

    Unplanned perioperative hypothermia is a common problem related to the induction of anesthesia. Vasodilation, caused by the anesthesia, allows warm blood from the body’s core to intermingle with blood from the 2° to 4°C cooler extremities; as it circulates, the blood cools and upon returning to the heart, it causes the core temperature to drop.

    According to the American Society of PeriAnesthesia Nurses’ (ASPAN) Clinical Guideline for the Prevention of Unplanned Perioperative Hypothermia, normothermia is a core temperature range from 36° to 38°C (96.8° to 100.4°F) and hypothermia is a core temperature less than 36°C. 

    Within 30 minutes of anesthesia induction, core heat that is redistributed to peripheral body parts can result in a core temperature decrease of 0.5° to 1.5°C.  Infrared tympanic monitoring is most commonly used to measure temperature pre- and postoperatively.

    Hypothermia affects coagulation, raises postoperative oxygen consumption by shivering, increases cardiac morbidity, leads to a higher incidence of wound infection and prolongs hospital stays, as well as increases recovery times. Anesthesiologists and medical researchers in thermoregulation list “low temperature of the patient before induction” among the top eight most important risk factors for hypothermia, according to a 2002 study published in Anesthesia & Analgesia.

    The prevention of perioperative hypothermia improves patients’ outcomes, allows them to experience a greater level of comfort, avoids postoperative shivering, and can help patients remain calmer before and after surgery.

    Traditionally, warmed cotton blankets have been used to help patients maintain normothermia; however, the heat in warmed blankets dissipates quickly and a 2002 study published in Surgical Services Management found that the average surgical patient needed nine cotton blankets during the perioperative period.

    Fortunately, nurses and clinicians can now provide their patients with an alternative. The Bair Paws® hospital gown by Arizant Healthcare, Inc., is an FDA-approved, single-use, wrap-around gown with the added benefit of forced-air warming built directly into the gown – making it a “warming gown.” It is made from a thick, flannel-like fabric called Softesse, which is manufactured by DuPont.  The gown is also comfortable to wear and provides more material and side ties for better coverage, unlike thin, drafty hospital gowns.

    As part of the Bair Paws Patient Adjustable Warming System, this “first-of-its-kind” warming gown is used in conjunction with the Bair Hugger® warming unit, which continuously blows warm air through a hose into the gown via tiny perforations in the gown’s air channels, causing the gown to inflate. This allows the proper amount of warm air to reach the patient’s skin surface.

    Using a handheld temperature controller, patients can control their own thermal comfort while waiting for their surgical procedure or afterwards in the post-op unit. Clinicians and nurses control clinical warming during the surgical procedure in the operating room or in PACU.

    Studies have shown that surgical patients warmed with forced-air warming blankets prior to surgery have less or no perioperative hypothermia. Pre-warming increases the temperature of peripheral parts of the body, limiting the amount of heat lost from the core through redistribution hypothermia.

    Additionally, patients actively warmed with a forced-air warming device for about 50 minutes before the induction of anesthesia were found to have statistically higher core temperatures after 30, 60 and 90-minute intervals than patients warmed with blankets for about one to two hours.

    A comparison study on the effects of pre-warming patients in the outpatient surgery setting found that patients in the forced-air warming group had significantly higher temperatures on arrival to PACU from the OR than did patients in the warm blanket group.

    In addition to the prevention of perioperative hypothermia, the Bair Paws system saves times and trouble for the surgery teams. “Less cotton blankets are used, which deceases laundry cost, as well as stocking time, calling for additional blankets several times per day and going back and forth to the warmer several times during the patient’s stay in one area,” according to Sue Bartoszewski, RN, surgical services manager for Centegra Health System at Northern Illinois Medical Center in a letter to Arizant Healthcare.

    Patients using a pre-warming system also experienced a significant reduction in preoperative anxiety.  “The [Bair Paws] gowns seem to be a great comfort measure,” writes Jenny Clevinger, RN, of Sapling Grove Surgery Center in Tennessee. “People put them on, lay down and relax. I’ve had patients refer to it as the spa treatment.”


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