Intraoperative temperature monitoring: Safeguarding against perioperative hypothermia & Malignant hyperthermia
Understanding Perioperative Hypothermia
Perioperative hypothermia occurs when a patient's body temperature drops below 36°C during surgery. This temperature decline can result from various factors, including exposure to cold operating room environments, cold prep solutions, anaesthesia-induced inhibition of thermoregulation, and the administration of intravenous fluids at room temperature. The consequences of perioperative hypothermia extend beyond mere discomfort, potentially leading to increased surgical site infections, higher blood loss, delayed wound healing, and prolonged recovery times.
Mitigating the Risks of Perioperative Hypothermia
To mitigate the risks of perioperative hypothermia, vigilant temperature monitoring throughout the surgical procedure is essential. Intraoperative temperature monitoring allows nurses to promptly identify any deviations from the normal range and implement preventive measures accordingly. Techniques such as forced-air warming systems, warmed intravenous fluids, and preoperative patient warming can help maintain normothermia and mitigate the adverse effects of hypothermia.
Identifying Malignant Hyperthermia
While hypothermia poses its challenges, nurses must also be vigilant for the opposite extreme: malignant hyperthermia. This rare but potentially life-threatening condition is characterised by a rapid and uncontrolled increase in body temperature, often triggered by exposure to certain anaesthetic agents, particularly in susceptible individuals. Prompt recognition and intervention are crucial in managing malignant hyperthermia to prevent severe complications such as muscle rigidity, metabolic acidosis, and even cardiac arrest.
The Role of Intraoperative Temperature Monitoring
Intraoperative temperature monitoring serves as a simple strategy for preventing perioperative hypothermia and in conjunction with ETCO2 monitoring assisting with the detection & management of malignant hyperthermia. By continuously monitoring core body temperature using advanced thermoregulatory devices, nurses can promptly detect deviations from the normal range and intervene accordingly. Furthermore, vigilant observation for signs such as shivering, altered mental status, and muscle rigidity can aid in the early identification of temperature-related complications.
Don’t overlook the importance of monitoring
Intraoperative temperature monitoring is not merely a routine task but a critical aspect of perioperative care. By diligently monitoring patients' temperatures throughout surgery, you can effectively prevent perioperative hypothermia, mitigate its associated risks, and promptly identify and manage potentially life-threatening conditions such as malignant hyperthermia. As advocates for patient safety, the importance of temperature monitoring should never be overlooked in its importance for ensuring optimal outcomes for every individual under our care.
Related courses
- Perioperative Nursing Update - Module 2: Delivered over 2 webinars and interactive eLearning case studies, this module explores a comprehensive approach to patient monitoring in the intraoperative and post operative environments following recommendations as outlined in the ANZCA PS18 document Monitoring during anaesthesia and recovery.
- Critical Bytes - Malignant hyperthermia: This webinar is suited to those working in a perioperative or critical care environment where inhalation anaesthetic gases or succinylcholine are used and for a deeper understanding of the physiology, recognition and management of malignant hyperthermia.
DebEvans, RN, BSc, DipAnaes&PostAnaesNsg, CritCareCert, DipProfStudies, Teach&AssessClin.PractCert, CertIV(TAE) has extensive background in Perioperative education and management. Deb has worked overseas and in several tertiary hospitals in Brisbane as an educator and manager including the Mater & The Wesley Hospital where she was awarded CEO Award for Innovation and Excellence and The Spirit of Wesley Staff Award for commitment to Quality and Safety.
Deb has developed blended education programs within the perioperative environment to include; Graduate transition programs; Clinical mandatory training; Corporate required learning & Point of Care SIMs; Perioperative competency development skills and speciality training programs. She recently worked for Montserrat Day Hospitals as the National Education & Training Manager and implemented a virtual orientation program, LMS & introduced speciality learning pathways. Deb has also been an ALS instructor & involved with a range of universities as a clinical facilitator and a lecturer at TAFE.
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