Hypothermia prevention by Emma Horsey RVN

Maintaining normal temperature is important for normal body function and metabolism.? Hypothermia in pets can drastically impact drug metabolism, trigger dangerous heart arrhythmias and cardiovascular depression, heighten the risk of infections and affects blood supply to wounds.??

Uncover a step-by-step guide to prevent hypothermia under sedation or anaesthesia.?

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STEP ONE: How big is my patient??

Smaller animals have a higher surface area relative to their size, making them more susceptible to rapid heat loss. In other words, the smaller they are the faster they get cold!?

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STEP TWO: How hairy is my patient??

Assess the thickness and type of your patient's fur. A dense coat provides natural insulation, while hairless or short-haired animals are more vulnerable to rapid heat loss.??

For hairless patients, ensure you use additional padding between heat sources to prevent burns and maintain safe, effective warmth.?

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STEP THREE: Is my patient already hypothermic???

These patients will need active warming, such forced warm air devices.??

Before proceeding to theatre, aim to maintain a normothermic state, ideally higher than 37°C.?

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STEP FOUR: How much of my patient will be effectively covered during surgery???

Larger the surgical sites lead to less coverage with insultation or heat sources. Similarly, the type of surgery will depict the area you can cover (an abdominal surgery will be more limiting than an orthopaedic one). In these cases, pre-warming, active-warming and covering as much as you can, will make a difference.??

While covering patients is helpful in preventing hypothermia, ensure you always have clear and quick IV access in a case in the case of an emergency, especially in unstable patients or risky procedures.?

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STEP FIVE: Could my patient benefit from being on the cooler side???

For stressed or brachycephalic patients, balancing temperature is crucial. Avoid extremes; aim for a temperature that is neither too warm nor too cold. Being on the lower range of normothermia (around 38°C) help some patients recover more comfortably without excessive panting.??

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STEP SIX: What types of active warming equipment do I have access to???

Forced warm air devices such as Bair Huggers with blankets attached is one of the most effective types of equipment. Tip: scrub trousers tied off at the legs and attached to them make for great enveloping blankets!?

Electric mats should always be used if instructions for safe use are followed. Others are IV drip warmers, fluid bag incubators etc. However, these latter ones are very ineffective.?

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STEP SEVEN: What types of inactive warming do I have??

There are four mechanisms for body heat loss: radiation, evaporation, conduction and convection. Surprisingly, radiation accounts for 60% of total heat loss! This is why foil blankets (space blankets) can be extremely useful.?

Apart from foil, there are many other things we can use: HME (heat and moisture exchangers), blankets, bubble wrap, warm lavage fluids, baby socks and vests, etc.??

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ABSOLUTELY ALWAYS:?

• Monitor your patient’s temperature and skin appearance and feel (for early detection of skin heat damage)?

• Plan for the future. Long procedures, frequent moving from one room to another etc.?

• Notice trends and take action as soon as possible.??

• Learn from previous cases.?

• Record everything you do.?

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ABSOLUTELY DO NOT:?

• Do not use active warming items that do not have a thermostat to maintain a safe temperature?

• Do not point hot air directly at the animal, even if it’s a low temperature?

• Do not put a patient in direct contact with a heat mat?

• Do not put an IV warming device too close to a patient?

• Do not use socks or bubble wrap on conscious animals encase of ingestion?

• Do not use metal blankets on conscious animals as the noise can be scary?

• Do not cause unnecessary stress to a scared, painful or patients with fragile eyes.?

• Do not use active warming device without frequently monitoring patients’ temperature and the area of contact. Thermal burns cannot always be immediately seen?

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USEFUL TIPS?

• Cut foil blankets to appropriate size.??

• Wrap foil blankets, soft bandage or bubble wrap around legs/paws.?

• Put a coat on your patient to keep warm if they won't tolerate a blanket.?

• Place a thin or lightweight blanket over the top of a hot air active warming device to allow the hot air to move around under the blanket.??

• Be creative! Booties, holes through covers for IV access, frames for warm air tents...??

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