“If You Start Cold You End Up Cold” An Audit on Evalution of ‘HotDog’ Patient Warming Devices
Introduction: Inadvertent hypothermia, which is defined as temperature below 36°C, is common in the perioperative setting. Perioperative hypothermia is associated with poor outcomes. The risk factors for the occurrence of hypothermia include regional anaesthesia, blood loss, cold fluid administration (All common to obstetric patients). NICE guidelines on perioperative hypothermia do not include parturient, but they are at risk group . Intraoperative forced air-warming used during caesarean delivery under spinal anaesthesia does not prevent maternal hypothermia.
Method: Our aim was to assess the effectiveness of our own design of “Hot seat” at St. Mary’s. It was a prospective audit Sept/Oct 2015 on elective caesarean section. The data was collected on ambient theatre temperature, anaesthetic type, estimated blood loss, temperature pre, intra and postoperative.
Result: In our audit 19% patients had preoperative temp of <36o, 21% patients had temperature of 36 -36.5o and 60% of patients had temperature of >36.5o. Most of the parturient used hot seat in waiting. In patients who were hypothermic i.e. <36o in pre op and used hot seat 20% had rise of temp to >36o, 60% maintained the temp and 20% had 0.2o drop in temp in preop period. The use of Hot dog products and especially chair in waiting area has reduced the patients with temp <36o from 13% to 3% in comparison to previous audit and has risen the patients with temp>36o from 87% to 97% post operatively.
Discussion:Hotdog controllers are compact and virtually silent. It has the most flexible and safest warming mattress available without air hose or water channels. St. Mary’s hospital design of hot seat on which patients wait preoperatively is effective as they are warm to start with and give mothers a warm welcome to theatre suite.