GUIDELINES AIMED AT MAINTAINING OPTIMAL BODY TEMPERATURE DURING "SURGICAL PROCEDURES.”

 

                            

Theatre Nurses: Guardians of Patient Temperature

Theatre nurses, along with the entire Theatre team, are responsible for managing patient temperature and preventing hypothermia during surgery. Hypothermia, defined as a core body temperature below 36°C (96.8°F), can lead to serious complications, including increased blood loss, higher infection rates, delayed wound healing, and prolonged recovery times. The Association of Theatre Registered Nurses emphasizes the importance of maintaining normothermia—keeping the patient's body temperature within the normal range—throughout the Theatre period to ensure optimal surgical outcomes.

Theatre Nurses’ Role in Temperature Management

From the moment a patient enters the surgical pathway, Theatre nurses are responsible for collaboratively assessing and managing temperature-related risks. During the preoperative phase, nurses perform a thorough evaluation to identify patients at higher risk for hypothermia, such as those with low body mass index, older adults, or those undergoing procedures longer than two hours. This assessment guides the development of individualized temperature management plans, tailored to each patient's needs.

In the intraoperative phase, Theatre nurses collaborate with anesthesia professionals to actively monitor and maintain patient temperature. They ensure that the operating room environment is conducive to maintaining normothermia, adjusting room temperatures as necessary and minimizing patient exposure to cold environments. Theatre nurses are also responsible for applying active warming devices, such as forced air or conductive warming blankets, to keep the patient's core temperature stable.

Strategies to Prevent Theatre Hypothermia

The Guideline for Prevention of Hypothermia recommends evidence-based strategies to prevent adverse patient outcomes. One method is prewarming patients with forced air warming systems for at least 30 minutes before anesthesia induction. This practice helps reduce the redistribution of body heat that often occurs after beginning anesthesia, which can lead to a rapid drop in core temperature.

During surgery, Theatre teams use multiple warming techniques to maintain normothermia, including:

• Active warming devices: Warming blankets or gowns, which are placed on the patient during surgery, as well as other devices like heating pads, warming mattresses, resistive fabric warming devices and radiant warmers, are essential tools in preventing temperature drops.
• Warming intravenous fluids and surgical irrigation solutions: Administering warmed fluids helps prevent the introduction of cold substances into the patient's body, which can lower core temperature.

Recommendations for Maintaining Normothermia

Maintaining normothermia requires a coordinated effort among the surgical team, with Theatre nurses playing a central role.    recommends that Theatre teams establish and adhere to a comprehensive temperature management protocol. This protocol should include:

• Preoperative warming: As previously mentioned, prewarming patients is a critical step. The literature recommends that prewarming begins at least 10 to 30 minutes before anesthesia induction to maximize its effectiveness.
• Intraoperative warming: Theatre teams should use a combination of active warming devices and warmed fluids to maintain temperature during surgery. This multi-modal approach is more effective than relying on a single method.
• Postoperative monitoring: Temperature management doesn’t end when the surgery is complete. Theatre nurses continue to monitor and manage patient temperature in the recovery room to ensure normothermia is maintained and to prevent any delayed hypothermia.

Theatre nurses play an indispensable role in preventing hypothermia and ensuring patient safety during surgery. By following guidelines and employing a combination of prewarming, active intraoperative warming, and vigilant temperature monitoring, Theatre teams can effectively maintain normothermia and improve surgical outcomes. Their expertise and diligence are key to minimizing the risks associated with hypothermia and enhancing the overall quality of Theatre care.