The challenge of temperature management has been met with an overwhelming response of new products, including forced air warmers; warming mattresses and blankets; and warming cabinets for blankets and fluids. Surgical Products connected with suppliers to figure out how surgical teams can continue keeping patients safe as new technology is being released.
The viewpoints expressed by suppliers are their own and not shared by Surgical Products.
Has the healthcare marketplace elevated the importance of temperature management?
Matthew Rotterman, vice president of sales at Enthermics Medical Systems: Yes, with an increased focus being placed on avoiding hypothermia, clinicians are taking greater steps to avoid it. Some steps include: providing warm fluids and warm blankets and using wearable warming garments. Avoiding hypothermia during surgery can reduce the risk for surgical site infections by up to 66 percent, which leads to increased clinical outcomes in a greater overall patient experience. Helping to drive compliance is the fact that Medicare reimbursements are tied to clinical outcomes, and temperature management is one of the areas that is measured.
Mary Pellegrom, director of marketing at EcoLab: A common question from clinicians is when to use an irrigation fluid warming system. OR staff should consider a fluid warming system for any surgery requiring a liter or more of saline for irrigation. According to the Association of periOperative Registered Nurses (AORN) and American Society of PeriAnesthesia Nurses (ASPAN), the use of warm irrigation fluid should be considered during surgery to help maintain patient normothermia. AORN also states that irrigation fluids should be at a known temperature at the time of installation in its 2014 guidelines.
What should facilities be aware of before they make purchasing decisions?
Troy Bergstrom, marketing communications manager of patient warming at 3M: With patient warming gaining greater attention as a key tool in infection prevention efforts, more and more companies are entering the market touting their products as the latest and greatest warming option.
Now, more than ever, hospitals should ensure products being considered have ample clinical evidence to demonstrate that they help patients achieve normothermia under actual surgical conditions. It is important to challenge product claims that fly in the face of published research or your own clinical experience. Ask for efficacy studies and learn the facts.
Are there still out-of-date tools and methods being used?
Kent Ellis, inventor and principal of Pintler Medical Patient Warming and Pressure Reduction: Many facilities are married to underbody water pads for warming. This is a practice dating back to the 1970s. Water as a warming product is a skin issue, and when foam is added, the benefit of water warming is insulated. Perfusion controls temperature very well and has for years. It can do all the temperature control, and, when the patient comes off the pump, let conductive warming maintain the 36 degrees C.
Forced-air warming (FAW) systems were introduced in 1987 as a safe, reliable way to increase patient comfort while also improving patient outcomes. Recently, the safety of FAW in orthopedic surgeries has been questioned. Surgical Products does not endorse viewpoints, and instead provides a forum for all points of view to be shared.
Dr. Scott Augustine, anesthesiologist and inventor at Augustine Temperature Management, expresses his concerns: FAW is an out-of-date tool even though it’s still used regularly. Almost 20 years ago, FAW became the standard of care because it was the best available technology. Now, it has been discovered that FAW has an unintended consequence: the waste hot air vents near the floor, heats the contaminated air resident near the floor, and then rises alongside the table into the sterile surgical field. One study showed 2000 times more airborne particles were present near the surgical site when FAW was used compared to air-free conductive fabric warming.
Based on the research, many facilities have discontinued warming in orthopedics. That’s concerning because hypothermia has been shown in many studies to adversely affect outcomes. Many clinicians do not know that there are air-free alternatives.
This article was featured in the November/ December 2015 issue of Surgical Products. To see the complete issue, click HERE.