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Active warming in obstetric theatres - three completed service reviews

Thursday, 22 May, 2014 - 11:10
Board 5

Poster Presenter: Mari Waltersmari.walters.briggs@gmail.com
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Epidural & equipment

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Service Evaluation

A completed service review cycle of temperature management and warming during obstetric procedures
Walters M, Ahmad N, Aluri S, Berwertz M, Roberts F, Woolnough M      Sheffield Teaching Hospitals NHS Foundation Trust

§The Jessop Hospital for Women is the tertiary obstetric centre for Sheffield and South Yorkshire, with 8000 deliveries per year.
§Inadvertent peri-operative hypothermia occurs commonly during both general and regional anaesthesia1.
§The National Institute for Health and Care Excellence (NICE) recommends temperature be measured regularly for all procedures
§NICE recommends that all procedures longer than 30 minutes should be actively warmed but specifically excludes obstetric patients1.
§Obstetric cases in our unit often seemed cold post-operatively

Temperature management before and during obstetric operative procedures was poor initially, but has made some improvement.
Forced air warming reduced rates of inadvertent hypothermia by half, while inditherm reduced rates to a quarter of original levels.
Forced air warming with an under-body warmer can only be practically used during procedures in the supine position and despite being routine practice in our unit, was not used universally. 
Our data suggest that the use of either active warming modality helps reduce inadvertent peri-operative hypothermia, and reduces fluctuations in core temperature.  Inditherm may be more effective and a more practical solution in obstetric anaesthetic practice. 
Using this evidence, an adequately powered, randomised controlled trial to assess effectiveness and compare the two warming devices in the obstetric population is awaiting ethics approval.