References
Unintentional hypothermia: implications and management of the post-operative patient
Abstract
Inadvertent hypothermia is not uncommon in the immediate post-operative period and is associated with impairment and abnormalities in various organs and systems that can lead to adverse outcomes. While there is much research to support the negative effects of hypothermia, often the focus is aimed towards minimizing heat loss in the peri and intra-operative period, however patients continue to lose heat post operatively, which can contribute to both short and long-term problems. Veterinary nurses have a pivotal role to play in minimizing such losses, with the main objectives consisting of detecting and recording post-operative hypothermia, as well as minimizing further heat loss and correcting any temperature deficits. Simple nursing interventions including careful positioning of post-operative patients away from draughty areas of the ward, frequent monitoring and recording of body temperature, and a combination of passive and active rewarming techniques can prove extremely beneficial to the recovery of hypothermic patients in the postoperative period.
Using the recommendations highlighted within this article it may be possible to minimize the physiological effects of hypothermia as well as to improve patient comfort during this important recovery phase.
Temperature control is a fine balance between heat loss and heat gain. When an animal undergoes surgery, the normal mechanisms responsible for generating and conserving heat are suppressed so the balance is heavily tipped in favour of heat loss. In addition the theatre environment and surgical procedure will impose large thermal stresses on the patient.
While it is well documented that surgical patients lose heat, the negative impact of such heat loss is greatly underestimated. A possible reason why this problem has not received the attention it deserves may be because the consequences of a decreased body temperature are invariably masked by, and mistaken for, the effects of surgery, rather than sometimes simply the fact that the patient is cold (McNeil, 1998). Although efforts aimed at averting hypothermia peri and intra-operatively exist, patients continue to enter the post-operative recovery period hypothermic with temperatures frequently below 34°C in cats and dogs (Dunlop, 2010). If nothing is done to correct this, the patient will continue to lose heat in the post-operative period with potential serious complications.
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