Help! This postanesthesia care unit patient is hypothermic

Hypothermia is a common intraoperative and immediate postoperative complication. Hypothermia causes morbidity from shivering, hypotension, cyanosis, and respiratory diseases. In severe cases, bradycardia, premature ventricular contractions, and even ventricular fibrillation may occur. The various causes of excessive heat loss, both intraoperatively and during the postanesthesia period, the methods of prevention, and the rewarming measures are important factors in administering patient care. Predisposing factors are large exposed body surface areas, open body cavities, prolonged exposure to low operating room temperature, rapid infusion of cold blood and intravenous (IV) fluids, cold irrigating solutions, ventilation with cold gases in long surgical procedures, age over 60 years, premedication that relaxes muscle tone, and the subcutaneous vasodilatation that occurs during anesthesia. Attempted prevention measures include active warming blankets, increased ambient temperatures, warmed IV and irrigating solutions, and metallized plastic sheeting. Restoration of normal body temperature is achieved by radiant heaters, heated mattresses, and heated humidifiers. Astute assessment, quick response, and correct interventions by the nurse can often minimize risk of postanesthesia hypothermia. These principles are illustrated in a case study of a PACU patient in a large teaching trauma hospital.