AB234. Incidence of perioperative hypothermia in patients undergoing surgery

Background: This audit aimed to evaluate the current adherence of the Department of Anaesthesia, University Hospital Limerick to the National Institute for Health and Care Excellence (NICE) Guidelines on Hypothermia: prevention and management in adults having surgery, 2008 (updated 2016).

Methods: Data was collected using a questionnaire completed postoperatively by post anaesthesia care unit (PACU) nursing staff over a four-week period. Data was filled out using details from each patient’s completed anaesthetic sheet as well as PACU nursing notes prior to patient ward transfer. Both adult and paediatric patients, as well as elective and emergency cases involving all surgical specialties were included in the audit. Questions addressed whether appropriate identification and management of hypothermia in the perioperative period occurred.

Results: One hundred and thirty-five patients were included in the audit. Fourteen percent of patients had their temperature recorded pre-operatively and of those undergoing operations greater than 30 minutes, 11% had their temperature recorded on one or more occasions. Seventy-nine percent of patients receiving forced air warming device (e.g., bear hugger) for operations greater than 30 minutes. Sixty-seven percent had temperatures below 36 degrees on arrival to recovery. Ninety-nine percent of patients underwent temperature assessments on arrival to the PACU with 97% also receiving warming prior to ward transfer.

Conclusions: The results suggest poor compliance with the NICE guidelines. The findings indicate that the majority of patients are arriving to the PACU with inappropriately low temperatures, most likely as a result of insufficient monitoring and management of hypothermia intraoperatively. Excellent compliance is noted postoperatively in the PACU however.

Keywords: Hypothermia; management; prevention; perioperative