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The Management of Inadvertent Perioperative Hypothermia in Adults

NICE Clinical Guidelines, No. 65

National Collaborating Centre for Nursing and Supportive Care (UK).

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Excerpt

Inadvertent perioperative hypothermia is a common but preventable complication of perioperative procedures, which is associated with poor outcomes for patients. Inadvertent perioperative hypothermia should be distinguished from the deliberate induction of hypothermia for medical reasons, which is not covered by this guideline.

In this guideline, hypothermia is defined as a patient core temperature of below 36.0°C. Hereafter, ‘temperature’ is used to denote core temperature. Adult surgical patients are at risk of developing hypothermia at any stage of the perioperative pathway. In the guideline, the perioperative pathway is divided into three phases: the preoperative phase is defined as the 1 hour before induction of anaesthesia (when the patient is prepared for surgery on the ward or in the emergency department), the intraoperative phase is defined as total anaesthesia time, and the postoperative phase is defined as the 24 hours after entry into the recovery area in the theatre suite (which will include transfer to and time spent on the ward). The phrase ‘comfortably warm’ is used in recommendations relating to both the preoperative and postoperative phases, and refers to the expected normal temperature range of adult patients (between 36.5°C and 37.5°C).

Contents

National Collaborating Centre for Nursing and Supportive Care: This guideline was developed by the National Collaborating Centre for Nursing and Supportive Care (NCCNSC) on behalf of the National Institute for Health and Clinical Excellence (NICE). The guideline was commissioned and funded by NICE and developed in accordance with NICE processes and methodologies.

Based at the Royal College of Nursing, the NCCNSC is a partnership of organisations brought together for the purposes of supporting the development of NICE clinical practice guidelines. The partnership is comprised of representatives from the following organisations: Centre for Evidence-Based Medicine, University of York, Clinical Effectiveness Forum for Allied Health Professions, Healthcare Libraries, University of Oxford, Health Economics Research Centre, University of Oxford, Royal College of Nursing, UK Cochrane Centre.

Disclaimer: As with any clinical practice guideline, the recommendations contained in this guideline may not be appropriate in all circumstances. A limitation of a guideline is that it simplifies clinical decision-making (Shiffman 1997). Decisions to adopt any particular recommendations must be made by practitioners in the context of:

  • Available resources
  • Local services, policies and protocols
  • The circumstances and wishes of the patient
  • Available personnel and devices
  • Clinical experience of the practitioner
  • Knowledge of more recent research findings.

Copyright © 2008, National Collaborating Centre for Nursing and Supportive Care.

PMID: 21678626

NICE (National Institute for Health and Care Excellence)

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