he spontaneous lowering of core body temperature below 360 F is inadvertent hypothermia (Hart, 2011). The unwarmed surgical patient usually presented with this feature. Perioperative hypothermia had a potential for morbidity and mortality…
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Perioperative hypothermia had a potential for morbidity and mortality. The patients who had perioperative hypothermia had a chance for surgical site infections especially in patients with colorectal surgery (Hart et al, 2011). The guidelines of Surgical Care Improvement Project encouraged the decrease in incidence of this illness. Human beings required internal body temperatures to be constant for the multiple organs to function optimally. The situation changed when the patient entered the operation theatre. The temperatures of the operation rooms were kept below 230C. Almost all the surgeries required this temperature for maintenance of normothermia for the reason that the operation theatre staff found the temperature for normothermia slightly warm for work. This caused the maintenance of lower temperatures in the theatre. Actual heat loss was governed by room temperature as the temperature gradient determined the heat loss. Surgeons and other staff could not withstand the warmth because of the stress of surgery and the layers of clothing they wore and the lead aprons. Prevention of perspiration was essential to avoid the problem of sweat polluting the surgical site. Staff could generally become lethargic with the higher room temperature hindering their vigilance which was critical in the operation theatre. However patients commented about the cold room. Inadvertent hypothermia is the aspect of care that has been selected by this researcher for study. Information on the issue of hypothermia was gathered from review of literature beginning with the study by Hart et al (2011). The review of literature provided plenty of basic information that could help readers to understand this topic of management of inadvertent hypothermia better. This researcher has carefully selected articles most recently published from the Pubmed Central site. Analysis of current evidence base Perioperative hypothermia Perioperative hypothermia of below 360C was experienced by 20% of patients (Kurz, 2008). Anaesthesia rendered a patient devoid of many defensive mechanisms for becoming warmer in the instance of hypothermia. Behavioural modification was eliminated so that patients became colder. Thermoregulatory mechanisms did not function so unwarmed patients became hypothermic. Perioperative hypothermia produced adverse effects like elevated loss of blood during surgery, a higher rate by 20% of allogeneic transfusions and an increase of surgical site infections by three times (Hart et al, 2011). Prevention of hypothermia had guidelines instituted by the Surgical Care Improvement Project (SCIP) for operative and post-operative patients. Perioperative normothermia was to be maintained by warming devices. Staff providing the warming support was to be knowledgeable about the mechanisms of temperature regulation, perioperative hypothermia and the methods to prevent or manage hypothermia. Temperature monitoring Temperature monitoring became an essential component of perioperative care. Oral temperature measurement was the best technique according to the American Society of Perianesthesia Nurses (ASPAN). The same method of measurement needed to be maintained throughout perianaesthesia (Hart et al, 2011). The temperature at the depth of the thoracic, abdominal and central nervous systems was the core temperature. It was more consistently controlled and was 2-40C higher than skin temperature. The measurement was made at the distal end of the oesophagus, from a bladder with good urine flow, the nasopharynx and the pulmonary artery in general anaesthesia patients. The core temperature was the most reliable indicator of the thermal status (Sessler, 2008). Near-core temperatures were taken from the axillary area, rectum, bladder with low urinary flow and
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“Patient Care in Inadvertent Hypothermia Assignment”, n.d. https://studentshare.org/nursing/1393746-a-critical-evaluation-o-the-evidence-base-for-a.
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