Hypothermia might not even cross your mind when you think about having surgery. But it’s actually not unheard of in hospital operating rooms across the country – among children and adults.

When a person is under anesthesia, he or she loses the ability to regulate body temperature. This means that his or her body temperature mirrors that of the room. If the body cools down so much as to lead to mild hypothermia, this restricts the movement of white blood cells, which are important for fighting off bacteria. If white blood cells can’t travel where they need to, this increases the chance of a surgical site infection.

The staff at Nationwide Children’s has been implementing various interventions to eliminate the occurrence of mild hypothermia. Some of these include warming the operating room before the patient arrives and maintaining it during the procedure, using warming blankets during travel and warming the mattress that patients lie on during the operation.

Listen in as Dr. Tom Taghon, director for Anesthesia Services, and Mike Fetzer, quality service line coordinator for Perioperative Services, talk specifics on how Nationwide Children's Hospital is combating the cases of mild hypothermia, and how this is improving overall quality of care.

Transcript
[Music]

Rick McClead: Several research studies have demonstrated that various complications developed when surgery patients become cold while in the operating room. Surgical wound infection, increase surgical blood loss, cardiac arrhythmia, and prolonged post-operative hospitalization to name just a few, yet the operating rooms are really cold. What was being done to keep the kids warm while they're in the operating room. Mild surgical hypothermia, next on Children's on Quality.

[Music]

Welcome on Children's on Quality. With me to discuss the problem in surgical hypothermia is Dr. Tom Taghon, Quality Director for Anesthesia Services at Nationwide Children's Hospital. And Mike Fetzer, Quality Service Line Coordinator for Perioperative Services. Welcome to Children's on Quality.

Dr. Tom Taghon: Thank you. It's a pleasure to be here.

Mike Fetzer: Thank you.

01:00

Rick McClead: Dr. Taghon, I'd like to begin with you for our listeners. Please describe what we are talking about when we discuss hypothermia as a complication of surgery?

Tom Taghon: Sure. General anesthetics decrease your ability to maintain body temperatures. So, you essentially become poikilothermic, which is just a term that means you assume the temperature of the environment that you're in. So, if we don't take precautions to keep that room warm, and keep our patients warm, they will assume a very cold temperature during the case.

Rick McClead: And what kind of temperature ranges are we talking about?

Tom Taghon: So, we usually -our goal is to keep our patients above 36 degrees, between 36 and 38 degrees Celsius. So, we will take whatever precautions we need to maintain that range.

Rick McClead: Normal body temperature is 37..

Tom Taghon: 37.

Rick McClead: or 98.6. So, a degree or so on each side of that is what we're looking at for a normal temperature.

Tom Taghon: That's correct.

Rick McClead: What we're not talking about is therapeutic hypothermia, correct?

Tom Taghon: You're correct we are not. In this case is we're taking advantage of hypothermia for its neuro protective and cardio protective effects.

02:06

And quite often in the cardiac case we have a profusionist there who can regulate the body temperature very precisely, so they can warm those patients up at the end of the case.

Rick McClead: Well, I commented in the intro that the operating rooms are really cold. Why are they so cold?

Tom Taghon: That's a great question. I think we like to say that perhaps being cold will inhibit bacterial growth. But I think it's also a function of comfort for the staff, surgeons, and scrub nurses are typically wearing heavy gowns and gets very hot in those lights.

Rick McClead: Well,