Protecting patients in the Operating Room (OR) is a priority for any medical professional. Every task done is designed to help or reduce risks. Sanitation and sterilization help or reduces germs. Anesthesia helps or reduces pain and movement. High-tech procedures help eliminate organ damage and scarring, but what additional injury might happen during the procedure?
Hypothermia and Pressure Sores
Hypothermia, or a significant drop in patient body temperature, can occur as the result of anesthesia or other causes of heat loss in the OR. Complications of perioperative hypothermia can include greater intraoperative blood loss and the possible need for transfusions. Deep tissue injury can also occur due to patient weight and positioning. Minor injury may only be a bruise, but more serious injury can lead to an intraoperatively acquired pressure ulcer (IAPU).
This 2012 AORN literature review by Cynthia Fred, et al, notes that deep tissue injury may only show as a bruise or burn on the surface tissues and then later display a manifest ulcer. The study goes on to note a strong association between hypothermia, tissue viability and surgical site infections and state, "All surgical patients are at risk for developing unplanned perioperative hypothermia, ...". With that in mind, patients who were shown to be at higher risk for IAPU included:
- Patients with at least a 1º F drop in temperature
- Patients who are critically ill
- Low Braden Scale skin assessment scores
- Patients who are thin
IAPUs create a negative impact on the hospital in a number of ways.
- They put the patient at risk for infections which may affect the patient's health and well-being.
- They may extend the length of stay of the patient in the hospital increasing costs to the hospital that are no longer being reimbursed by Medicare and other third-party carriers.
- They may also cause the hospital to lose standing in national merit reporting agencies and their reputation in the community for quality care.
Reducing Risk With Normothermia
The answer appears to be that of keeping the patient's temperature within the normothermic range - considered to be 36º C to 38º C (96.8º F - 100.4º F). A complementary adjunct may be to provide a pressure reducing pad between the patient and the hard OR table.
One way to achieve this is to use a device like the Gelli-Roll® by CSZ Medical. This warming system is designed for the OR to provide patient temperature control and comfort during surgery. The Gelli-Roll® is a reusable water blanket encapsulated in Akton® polymer which allows the pressure of the patient's weight to be redistributed throughout the procedure, and also to provide warming to maintain normothermia when combined with the Norm-O-Temp® Hyperthermia System.
Surgery may always come with risk, so it's important to reduce risks wherever possible. Maintaining normothermia with a pressure reducing water-filled warming blanket to avoid hypothermic complications such as an IAPU is one area where you can take action.
For more information on CSZ, visit our website or call us at 800-989-7373.