July 2005 - The Hong Kong College of Anaesthesiologists

Perioperative NursingBull HK Coll Anaesthesiol Volume 14, Number 2 July 2005An audit of Perioperative Hypothermia in the Elderly Patients1Man Shan Ma, 2 Alick HF ChiuDepartment of Anaesthesiology, Operating Theatre and Sterile Supply, North District Hospital, Hong KongSUMMARYWe conducted an audit of temperature management in the perioperative period. Core temperature wasrecorded in the elderly patients using a tympanic thermometer during reception to the theater suite, 1and 3 hours after of surgery and upon admission to and discharge from the recovery room. We foundthat the use of force air warming device with hospital blanket reduce the incidence of hypothermia from7% to less than 1%. There was no evidence of thermal injury. We concluded that force air warming withhospital blanket is an effective, efficient way to maintain perioperative normothermia.Keywords: Geriatric; anesthesia, hypothermia, perioperative phase, force air warmingBull HK Coll Anaesthesiol 2005;14:90‐4Hypothermia is defined as coretemperature less than 36°C. 1‐6Inadvertent hypothermia is associatedwith a number of serious consequences. 6‐8Patient experienced hypothermia have increasedincidence of wound bleeding and infection,decreased cardiac function, delayed recoveryfrom anesthesia and a longer stay in theoperating room. 7,8 In March, 2000, we found that7% of all patients undergoing elective surgeryhad hypothermia during their stay in theoperating room. In this survey, we noted thatelderly patient are especially vulnerable becausethey have less subcutaneous fat, decreasedmetabolic rate and impaired cold sensation.In the literature, a number of interventionsare shown to be effective in preventinghypothermia. Warmed intravenous fluid, cottonblanket and heated airway humidification weretechniques that are commonly applied in ourhospital. 9‐15 In this audit, we evaluated the use offorced air warming to prevent perioperativehypothermia in elderly patients scheduled forgeneral surgical procedures. The objective of theprogram was to limit the occurrence ofperioperative hypothermia to less than 7%among our target group of patients.Methods and Materials1RN, BN, Registered Nurse; 2RN, DepartmentOperation Manager. Department of Anaesthesiology,Operating Theatre and Sterile Supply, North DistrictHospital, Hong KongAddress correspondence to: MS Ma, DepartmentAnaesthesiology, Operating Theatre and SterileSupply, North District Hospital, 9 Po Kin Road,Sheung Shui, NT. E‐mail: mams323@yahoo.com.hkThe study was performed in the operatingtheatre of the North District Hospital. Theperioperative nursing team got together andformulated an action plan.Target patient group selectionThe team recognized patients more than 60years, of either gender, undergoing elective90