Procedural warming of patients with burns

Melinda Pacquola1, Anna Dykes2, Amelia Terracall3, Hana Menezes4, Jason McClure5, Heather Cleland6

1 The Alfred Hospital, 55 commercial road, Melbourne, Vic, 3004, m.pacquola@alfred.org.au
2 The Alfred Hospital, 55 commercial road, Melbourne, Vic, 3004, annadykes@gmail.com
3 The Alfred Hospital, 55 commercial road, Melbourne, Vic, 3004, a.terracall@alfred.org.au
4 The Alfred Hospital, 55 commercial road, Melbourne, Vic, 3004, h.menezes@alfred.org.au
5 The Alfred Hospital, 55 commercial road, Melbourne, Vic, 3004, j.mcclure@alfred.org.au

6 The Alfred Hospital, 55 commercial road, Melbourne, Vic, 3004, h.cleland@alfred.org.au

Background

Currently there is limited literature to guide best practice or method of maintenance of burn patient’s temperature during dressing changes.

Aim

The aim of this project was to observe if current practice, of temperature management during dressing changes, was effective in maintaining the patient’s temperature throughout the procedure.

Method

ICU burns patients with ≥ 20% total body surface area (TBSA) requiring a dressing change were warmed an hour pre and throughout procedure, with their temperature documented at hourly intervals. The current warming practice is a multimodal approach, fluid filled warming mat, space blanket and air filled warming blanket. Procedure duration, total body surface area (TBSA %) burnt and dressing products also recorded.

Results

There were 46 patients and 136 procedures. 89% of patients’ temperature did not drop below 36°C, with the dressing time averaging 3.4 hours. There was a strong correlation when the patient’s pre procedure temperature was higher and the patient’s temperature at the end of procedure also higher.  There are other factors which influenced temperature loss, such as, the patient’s TBSA%, dressing products and the temperature of solutions used.

Conclusion

The use of pre warming and a multimodal approach to warming patients during procedures seems to be effective in preventing hypothermia during and post procedure.

Key Words

Burns, temperature, hypothermia, dressing procedure, operating theatre

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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