Intraoperative and Postoperative Complications of Hypothermia

The preoperative phase begins when the decision to have surgery is made. It is used to assess the patients suitability for surgery, identify potential risk factors, educate the patient on avoiding complications of surgery and anaesthesia, and plan to meet the patients needs for a safe and sustained recovery upon discharge (Berman, 2014, p. 1015). This process includes addressing all parameters on the preoperative checklist. Fasting is an important part in the preoperative phase. Preoperative fasting is the practice of a patient abstaining from oral food and fluid intake for a certain amount of time before a surgical procedure is performed. This is intended to prevent pulmonary aspiration of stomach contents during general anaesthesia. When

Hypothermia can be prevented by maintaining a neutral thermal environment and reducing heat loss. For prevention in reduction of heat consider the four ways by which the neonate experiences heat loss and intervene appropriately.

On 01/27/2016, I observed about 22 patients in Postanesthesia Care Unit. Some of the patients were observed after surgeries while others were observed after endoscopy. During my shift, I observed patients awaiting recovery for removal of kidney stones, malignant melanoma (removal of moles), Endometrial Biopsy (EBX), superficial femoral artery (SFA), Hernia repair, Oophorectomy (ovary removal surgery), Cardiorrhaphy (Ventricular repair), Cystolithalopaxy (bladder stone removal), gall stone removal, Ectopic pregnancy surgery, and leg surgery.

b. The prevention and management of unintended hypothermia remain a nation priority in preventing surgical site infection, and it has been designated as an SCIP quality measure. (Philips, 2015)

The appropriate assessment of patients prior to surgery to identify coexisting medical problems and to plan peri-operative care is of increasing importance. The goals of peri-operative assessment are to identify important medical issues in order to optimise their treatment, inform the patient of the risks associated with surgery, and ensure care is provided in an appropriate environment secondly to identify important social issues which may have a bearing on the planned procedure and the recovery period and to familiarise the patient with the planned procedure and the hospital processes.(American Society of Anaesthesiologists)

The pre-operative stage is an important phase in patient’s surgery process. This is the time where the patients is experiencing a lot of anxiety issues and have questions regarding the impending procedure. To help ensure good patient outcomes, it is imperative to provide complete preoperative instructions and discharge instructions (Allison & George, 2014). It is the nurses’ duty to safe guard and protects the patient’s welfare during the surgical experience. Effective preoperative preparation is known to enhance postoperative pain management and recovery. Health professionals need to be cognizant of the contextual factors that influence patients’ preoperative experiences and give context appropriate care (Aziato & Adejumo, 2014).

Neira JA. Post-Resuscitation Care: Induced Hypothermia to Whom, How, and When? World Congress of Cardiology, 2008. Web. 4 June

In the last five years, Enhanced Recovery After Surgery (ERAS) pathways for colorectal resection have been thrust into spotlight with evidence of expedited recovery time and improved postoperative outcomes1–5. However, there exists little uniformity in the recommendations and results of published ERAS pathways, and there is some evidence suggesting that the wrong cocktail of bundle elements can increase Surgical Site Infection (SSI) rates6. This inconsistency can be attributed to a lack of consensus on the efficacy of some common bundle elements, such as preoperative antibacterial showering, maintenance of normothermia, and high intraoperative Fraction of Inspired Oxygen (Fi02) 7–15. Such dissonance in studied ERAS efforts

THT is the only therapy that has appeared to positively affect the neurological outcome of patients after cardiac arrest. THT has been around for more than fifty years. The history of the scope of THT is limited and the only consistent application of this therapy invasive surgery. Within the last 10 years, the benefits of induced therapeutic hypothermia have been rediscovered, mainly with the improvement in neurological outcomes in out-of-hospital cardiac arrest (OOHCA) victims. In addition, therapeutic hypothermia has been suggested to improve outcome in other neurological conditions such as traumatic brain injury, neonatal asphyxia, cerebrovascular accidents and intracranial

Articles discussing the accurate recordings of pediatric patient’s body temperature were cited in this article. A logical sequence is followed in the literature review. It begins with a general overview of the historical importance of accurately recording a patient’s body temperature. The authors get more specific and cite studies on temperature recording techniques in children. For instance, in justifying conflicting data, the researchers cite a similar study conducted on new born babies by Polit & Beck (2008), where the recordings from the two methods were

This is a mix of qualitative and quantitative research that uses descriptive and cross-sectional survey design methods to evaluate the patient’s anxiety level and discomfort preoperatively and postoperatively. The level of evidence in this study is III, with controlled trial without randomization (LoBiondo-Wood, 2013). Methods used to collect data are logical, as it corresponds to the phenomenon of interest in this research as listed in the critiquing guideline table in appendix A. This study was conducted in the general surgery unit of a university hospital in 2011 with a sample size of ninety-nine patients. Definitive features, visual analogue scale (VAS) and State and Trait Anxiety Inventory (STAI) tools were used to collect data, refer to appendix A for details. The fasting protocol reported by the nurses in the surgical unit was no solid food on the day before surgery after 10:00 p.m. and no liquid after 12:00 a.m. In the meantime, the patients were on isotonic sodium chloride from beginning of anaesthesia until the 24th hour postoperatively. The result shows that patients who fasted for more than twelve hours has significant increase in anxiety level according to the STAI score, and higher hunger, thirst, nausea, and pain as shown in VAS scores compared to the patients whom fasted for less than twelve

Pre-operative data collection was obtained in the ambulatory minor surgery unit (AMSU). A communication sheet was filled out that collects patient data such as their diagnosis, the procedure they are having, drug allergies, vital signs, IV placement, and their current medications. This information is documented by the AMSU

Before surgery, the anesthesiologist will evaluate the patient’s current and past health to create an anesthetic plan fit for the patient. During surgery, he/she will diagnose and treat any issues that might come up. This is considered a dangerous job because giving too much anesthetic can easily kill a patient and not giving enough can create a risk of the patient waking up or feeling some parts of the

During therapeutic hypothermia, body temperature is lowered to 89.6°F–93.2°F. The procedure is usually done as soon as possible after the heart is restarted and a pulse is felt. Cooling may last between 12-24 hours.

The management of postoperative pain has received much interest nowadays. The intensity of postoperative pain depends on many factors such as type and duration of the surgery, type of anesthesia and analgesia used, and the patient’s mental and emotional status (11).