WARM WELCOME The direct benefit of a warmed blanket lasts for only a few minutes, but it can improve a patient's comfort and sense of well-being for much longer.
You grab a heated blanket out of your warming cabinet and drape it on your patient without much thought. But there's a lot you might not realize about blanket warmers. What's the maximum blanket warmer temperature? Can warmed blankets burn a patient? Can you store fluids in the warming cabinet section? Give your staff this 8-question quiz to test their knowledge.
1. What is the suggested maximum temperature for the blanket section of your warming cabinets?
a. 100 ?F
b. 120 ?F
c. 130 ?F
d. 200 ?F
Show Answer
HOT TOPIC The recommended maximum temperature for warming cabinets is 130 ?F.
Answer: c
While there is limited research in establishing the maximum temperatures for blanket warming cabinets, ECRI Institute, an independent health device research firm in suburban Philadelphia, recommends a maximum temperature of 130 ?F and a temperature range of 120 ? to 130 ?F +/- 5 ?. That may be a safe threshold, but evidence to support it is lacking. In fact, a study published in the Journal of Perianesthesia Nursing indicates blankets lose heat quickly over time, patients prefer blankets warmed at higher cabinet temperatures and, most importantly, patients can safely receive 1 or 2 unfolded blankets warmed in 200 ?F cabinets. (osmag.net/NEm4Et). The study's authors stop short of suggesting you set your cabinets to that higher temperature. "Evaluate the research and consider your patient population," say Patricia A. Kelly, DNP, RN, CNS, AGN-BC, AOCN, and Susan Cooper, BSN, RN, CPAN, of Texas Health Presbyterian Hospital in Dallas. "The important goal is to establish cabinet temperatures based on evidence, while at the same time maintaining patient comfort and safety."
2. Is a warmed blanket likely to burn a patient?
a. yes
b. no
Show Answer
Answer: b
There are no reports of patient injury caused by warmed hospital blankets. Even blankets taken from warmers operated at temperatures up to 200 ?F have almost no effect on skin temperature (osmag.net/z2DJmF). Heated blankets transfer very little energy to a patient and cool substantially from the time you transport a blanket from a warmer until you drape it on a patient.
3. Can you put fluids in the warming cabinet section?
a. yes
b. no
Show Answer
Answer: b
Store IV and irrigation solutions, blankets and patient linens in separate warming cabinets or in cabinets with separate compartments that have independent temperature controls, per AORN Guidelines for Perioperative Practices (osmag.net/T5nrWU). Label your blanket warmers "for blankets only" to avoid confusion. ECRI Institute recommends heating surgical fluids to a maximum of 110 ?F. The guidance came in response to reports of fluid being stored in blanket warming units, which often heat contents to levels well above ECRI's suggested limit. Store irrigation and IV fluids in dedicated heating units and check the maximum allowable temperature allowed by the manufacturers of whatever fluid you're warming to ensure fluids are heated to an appropriate temperature.
4. Are you required to track and log the daily temperatures for blanket warmers?
a. yes
b. no
Show Answer
Answer: b
There are no recommended practices or requirements for doing so, but it's not a bad idea to test the temperature of blanket warming cabinets to ensure set temperatures are being adhered to. Perhaps perform weekly checks to ensure cabinets' temperatures haven't been adjusted above your facility's maximum setting.
5. Warmed blankets are indicated for __________ .
a. preventing surgical site infections
b. providing comfort care
c. reducing unplanned perioperative hypothermia
d. affecting a patient's sense of well-being
Answer: b and d
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Patients often say that receiving a warmed blanket has an instantaneous "good feel" to it. If the patient is hypothermic, active measures — or a combination of active warming and warmed cotton blankets — are needed to provide the required level of warmth. In the surgery setting, the use of warmed blankets improves the patient's perception of comfort. A warmed blanket is an easy and effective way to promote a caring atmosphere.
6. Guidelines for the safe use of warming cabinets include all except __________ .
a. store only dry cotton blankets
b. load blankets according to manufacturers' recommendations
c. monitor the warming cabinet equipment according to organizational policy
d. limit blanket warmer cabinets' use to blankets and moist packs
Show Answer
Answer: d
All warming units have alarms that alert staff if the in-cabinet temperature differs from the set temperature. Load blankets according to the warming cabinet manufacturer's directions for use. To ensure blankets are warmed safely and effectively, make sure the cabinet you use has enough space to hold the maximum amount of blankets you store at once — or don't overload the cabinet — to ensure enough space remains around the stack to allow adequate airflow around the chamber. Also load blankets well before they're needed, so they have plenty of time to reach the desired temperature.
7. Warmed cotton blankets are effective as a single intervention to treat unplanned hypothermia.
a. true
b. false
Show Answer
Answer: b
Research presented as a poster at the 2011 AORN Congress involved 30 patients who underwent outpatient open colorectal surgery. The patients had active warming applied 15 minutes before heading to the OR, during surgery and in PACU (osmag.net/SAX4ss). The research, performed by surgical nurses at the University of Maryland Medical Center in Baltimore, showed active warming maintained normothermia in all the patients while they were in pre-op and in most of the patients as they moved to the OR and the recovery unit. The nurses conducted the research after reviewing 10 clinical studies that demonstrated forced-air warming was more effective than warmed cotton blankets for maintaining normothermia. AORN also states that the collective evidence suggests a combination of active and passive warming may be the most effective way to stave off hypothermia.
8. According to the literature, thermal discomfort is associated with all of the following except __________ .
a. increased anxiety
b. distress
c. nausea
d. pain
Show Answer
Answer: c
A study in the AORN Journal says patients respond holistically to complex stimuli, so feeling cold is an uncomfortable feeling that can trigger anxiety about the surgery, the anesthesia, anticipated pain and being immobilized. "High levels of anxiety have been linked to tachycardia, hypertension, arrhythmias and increased pain — all factors that impede post-op healing," notes the study. Warming patients puts a positive spin on how they perceive potential threats to their well-being, and plays a vital role in how quickly they feel comfortable and confident enough to ambulate after surgery. OSM
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