Warming blankets make surgery more 'Bair'-able

Hospital staff have traditionally used warm flannel blankets to keep their patients warm before, during and after surgery. But the blankets don't really do a good enough job.

According to Dr. Brent Kennedy, a staff anaesthesiologist at Health Sciences North, a quality assurance study at the hospital earlier this year showed only 22 per cent of patients arriving in the recovery room after surgery had a normal body temperature.

Enter the Bair Hugger warming unit.

Since the equipment was introduced in July, patients who are due to undergo a surgery that will take at least an hour to complete put on a special gown known as the Bair Paws gown. It is attached to the warming unit, which circulates warm air through the gown.

The patients wear the gown for an hour before surgery to make sure they're not cooling down before entering the operating room. Patients themselves control the temperature of the air.

During surgery the patient is hooked up to yet another warming unit, which is controlled by the surgical team. Once they're in the recovery room, they're once again connected to a warming unit.

Because of the equipment, more than 70 per cent of patients now exit surgery with normal body temperatures.

“The understanding is when a patient is in the OR, they will drop their temperature — that is a given,” Carol Kirkwood, clinical manager of Health Sciences North's operating rooms and recovery rooms, said.

“If we bring them in already warmed, having not dropped their temperature ... what they drop (in the operating room) won't get them into a very cool body temperature range.

“Then from there, they can go to the recovery room, and we can continue to warm them there. So they're finishing their surgery at a warmer temperature than they would have had we not pre-warmed them.”

The devices are commonly used in the United States, she said. Health Sciences North is the first hospital in Northern Ontario and one of very few in the province to use them.

Clinical studies suggest that keeping patients at a constant warm temperature before, during and after surgery helps patients to avoid unintended hypothermia, or a body temperature below 36 degrees C.

They also show patients who maintain a normal body temperature are at lower risk of complications such as post-operative wound infections and heart attacks, Kennedy said.

Those with lower body temperatures are at a higher risk of wound infections because less infection-fighting white blood cells are circulating to their skin, he said.

Lower body temperatures also cause shivering, which increases the body's oxygen consumption and heart rate, which are both risk factors for heart attacks, Kennedy said.

What's more, the Bair Paws gowns also have a positive impact on patients' state of mind, Kirkwood said.

Patients often get chilly while waiting for their surgery in only a paper gown, she said. Many have said they appreciate being kept warm before going under the knife. Some even said they'd like to own one of the devices themselves.

“When you're not feeling well, wrapping yourself in a nice, warm blanket or using a hot water bottle does make us feel a little bit better, emotionally,” Kirkwood said.

“That's maybe a plus we're seeing that we did not expect .. anything that is positive like that is only better for our patients.”

The Bair Paws units have also acted as something of a conversation piece for those waiting for surgery, she said.

“It's breaking the ice, where there generally is a fair bit of anxiety at that point,” she said. “Patients are talking to each other and they're asking 'What is this gown and what is it trying to do?'”

In terms of the cost, Kirkwood said the hospital had been spending about $20 per surgical patient to wash the blankets used to keep them warm. Each Bair Paws gown costs about $20. The warming units themselves are provided by the company free of charge, as long as the hospital is purchasing the gowns.

“We're looking at a break-even,” she said. “When you put the business end and the clinical end together, it became something that our senior management was able to move forward with quite quickly.”

Health Sciences North president and CEO Dr. Denis Roy praised the initiative.

“HSN's surgical program is demonstrating leadership on a national scale when it comes to innovation,” he said, in a press release.

“Whether it's introducing new surgical procedures, equipment, or methods of care, the physicians and staff in the surgical program are constantly finding ways to improve surgical outcomes and the overall patient experience.”