Types Of Intraoperative Warming

The registered nurse must be observant of any clinical signs that require further assessment such as the signs and symptoms stated earlier in this paper. Previously, nurses were taught to use the Homan’s sign to assess for a DVT. After extensive research, it has been found that the Homan’s sign is not as effective as previously documented. Therefore, after additional research, the registered nurse can use the Wells model when assessing a patient for a DVT. The Wells model is a numerical scale similar to other scales used within the nursing practice and consists of a scoring system that predicts the likelihood of a DVT. The Wells model assesses for the following criteria: if a patient has active cancer, any paralysis, if the patient has been bedridden for more than 3 days or had a major surgery within the last 4 weeks, Is the patient experiencing any local tenderness, any swelling or pitting edema in the leg or calf, or is there an alternative diagnosis that is more likely than a DVT. These areas are scored with a number 1 if positive and a 0 if negative. A score of 3 or more would indicate a high probability for a DVT. A score of 1 or 2 would indicate a moderate probability, and a score of 0 would indicate a low probability of a DVT. When doing an assessment, the registered nurse can quickly use the Wells model to determine if further assessment is

Initially, cooling was recommended to 32° C-34° C[6, 7], but the enhanced effect of cooling at 33° C compared to 36° C in terms of mortality and neurological outcome could not be proven[2]. Since the most optimal cooling level is yet unknown, current (2015) Resuscitation Guidelines recommend mild hypothermia treatment regimen at the temperature range between 32° C and 36° C[3, 4].

Optimizing the thermal environment has proven significant for improving the chances of survival for small infants. Understanding the basic physiologic principles and current methodology of thermoregulation is important in the clinical care of these tiny infants.

ii. Hypothermia, defined as a core body temperature less than 36C, is a relatively common occurrence in the unwarmed surgical patient. A mild degree of perioperative hypothermia can be associated with significant morbidity and mortality. (Hart et al., 2011)

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).

"Therapeutic Hypothermia: The History of General Refrigeration." Resus Review. Charles Bruen, 1 Dec. 2013. Web. 1 June 2015.

There are two different types of anesthesia; which are local and general. Preoperative services, administration, post-op and monitoring is included in the anesthesia package. Codes for anesthesia codes are simpler that codes for surgery. Qualifying circumstances recognizes four conditions. (99100) which indicates younger than a one year old or older than a 70-year-old, (99116) entire body hyperthermia, (99135) hypotension under control, (99140) situations that are emergency. Anesthesia payment formula is base + time +modifying units x conversion.

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

These procedures are not reported alone but as add-on codes used to identify extraordinary conditions of patients and their unusual risk factors. There are four kinds of certain codes used for particular circumstances which are: 1) Anesthesia for the age younger than one year and over the age of seventy (99100), 2) Anesthesia complicated by the utilization of total body hypothermia (99116), 3) Anesthesia complicated by the utilization of controlled hypotension (99135) and 4)Anesthesia complicated by emergency circumstances

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

Mrs Abu has had a considerable change in her vital signs (blood pressure lowered, her pulse is rapid, her respirations increased and temperature has dropped) form the baseline taken before surgery. These findings alone would be reported to the Registered Nurse and monitored. But because of the changes in vital sings, coupled with Mrs Abu reporting light-headedness and

Therapeutic hypothermia can save lives, as well as maintain neurological proficiency. The risks however are ever-present. The possibility of developing a cardiac arrhythmia is very possible. The fact is however that the majority of cardiac arrhythmias do not present immediate or life threatening dangers. It is possible, yet uncommon, for the arrhythmia to pose serious effects on the circulatory system, and therefore seeing as this is the most common problem that s caused by the use of therapeutic hypothermia, when weighed against the possibility of preserving neurological function and or saving a life, the benefits can potentially often outweigh the risks. Though there are other, more serious problems that can arise due to the use of this treatment, they are far less common, and or

Ten patients were in a control group where no special precautions were taken, ten patients had preoperative and intraoperative active warming, and ten patients had intraoperative active warming only. By providing 45 minutes to 1 hour of pre-warming and intraoperative warming combined, hypothermia caused by general anesthesia was not experience. After induction the patients with just intraoperative warming were in a hypothermia state for at least the first two hours. It was not until the end of surgery that both groups (except the control group) were at a normothermia state.

During my rotation in the operating room at Community medical center, I observed the preoperative, intraoperative, and postoperative care for a patient who underwent a laparoscopic hysterectomy. I believe that an appropriate preoperative plan of care for this patient would have included a full physical exam and an interview for patient history, a pelvic exam to look over and understand the nature of the patient’s complications, blood testing including a CBC and WBC to note any signs of infection or contraindications for the procedure, and a urine test to rule out any urinary tract infections or pregnancy. It would be important to interview the patient and ask questions to determine how the patient is feeling about their procedure and to better assist with any anxiety or pain they may be dealing with preoperatively. It is important to consult with the patient well before the procedure to ensure that she knows to refrain from smoking for at least 8 weeks before the procedure because this reduces the risks of complications such as infections, issues with blood pressure, heart rate, blood flow, and respirations when under anesthesia, and promoting overall health and risks associated with smoking after the procedure. (ASAHQ) It is also important to educate the patient to consume no food or drinks after midnight the night before the scheduled procedure. (Health Communities) During my rotation I observed that the patient did indeed have labs drawn and a urine test run. Her lab