How do you recover a low temperature in surgery?

Re: How do you recover a low temperature in surgery?

Nicola Smith — Wed, 15 Dec 2010 19:03:38 GMT

We are small 1 vet practice too - recon ones arent too bad and at the end of the day consumables like the blankets can be charged out to the client, or for more routine stuff vet direct do washable ones if you cant stretch to disposables.

Re: How do you recover a low temperature in surgery?

Nick Shackleton — Wed, 15 Dec 2010 17:35:35 GMT

[quote user="Geniverger"]We are a small 1-vet practice so getting a bairhugger is sadly out of the question. I make it my mission during ops to make sure I keep the patients temperature up (or at least slow the inevitable drop). We use heat pads under the patient, wheaties, hot hands and blankets. I'm interested in getting some space blankets though (the foil ones) for the longer ops or shocky patients. To anyone who uses them; do you find they work really well? also where do you get them from and are they reusable? Cost is an important factor in whether I'll be allowed to order them!

[/quote]

AAS do a deal where if you buy so many blankets per year you'll get a free unit!

Re: How do you recover a low temperature in surgery?

Geniverger — Wed, 15 Dec 2010 09:30:29 GMT

We are a small 1-vet practice so getting a bairhugger is sadly out of the question. I make it my mission during ops to make sure I keep the patients temperature up (or at least slow the inevitable drop). We use heat pads under the patient, wheaties, hot hands and blankets. I'm interested in getting some space blankets though (the foil ones) for the longer ops or shocky patients. To anyone who uses them; do you find they work really well? also where do you get them from and are they reusable? Cost is an important factor in whether I'll be allowed to order them!

Re: How do you recover a low temperature in surgery?

Nicola Smith — Wed, 15 Dec 2010 08:12:19 GMT

We have recently invested in a reconditoned bair hugger and cant believe the differece it makes. Patients not getting hypothermic under GA even the criticals and we had a cat with very low temp in kennels and put him on that and was fine within about 20 mins. They do make such a difference and recon ones arent as expensive a you might think!

Re: How do you recover a low temperature in surgery?

Felicity Caldwell — Tue, 14 Dec 2010 23:33:16 GMT

Aww, bless you. Thats very sad - it is awful when they just dont do!

For our patients, we make sure they always have normal blankets, a 'space blanket' (foil emergency blanket), snuggle safes (very cozy, microwavable but take care that they dont cause burns as they can be VERY hot if overheated!!), drip line warmers, +/- a thermovet on the ET tube. The theatre tables have electric heat mats on them. We then make sure that all patients on recovery have all warming aids possible and they have a TPR every 15 minutes until up to body temp.

I find it quite handy to wrap paws and ears (around the head) in bits of bubble wrap or what I call 'space blanket'. You loose a fair amount of heat thro' extremities, obviously inspired gases are cold, major surgery can expose large areas for heat loss i.e. open abdo surgery etc. Clipping and preping can also affect heat loss (I am sure you know all this...but it was good to make me think!!)

However, some patients - despite how much you try to keep them warm do have drastic drops in body temp. Because we are orthopods/spinal vets - most of our patients can be anaesthetised for a long time. I find it very scarey if a cat returns back into recovery with temps of 32.0 - all attempts to preserve body temp should be made!!!

Re: How do you recover a low temperature in surgery?

Hannah Young — Tue, 30 Nov 2010 21:20:50 GMT

Due to the amount of shock it may be in would loose its temperature quickly.

We use

A Bairhugger, Vet beds, Hot Hands (Gloves), Heat pad, Infra red Heater which goes through to the tissues, blankets etc

Re: How do you recover a low temperature in surgery?

Emma Purnell — Sat, 27 Nov 2010 16:33:07 GMT

[quote user="GremlinNurse"]

So sad that little kitty didn't make it :( Do you know how the injury happened?

Sounds like you tried your best though x

[/quote]

She was hit by a car and then dragged down the road, degloving both back legs and pretty much the whole back of her.

Miraculously, we still don't know how, but we x-rayed her thoroughly and she had no fractures at all.

Still sad about her, amazing how some stick with you...

Re: How do you recover a low temperature in surgery?

GremlinNurse — Sat, 27 Nov 2010 11:52:14 GMT

So sad that little kitty didn't make it :( Do you know how the injury happened?

Sounds like you tried your best though x

Re: How do you recover a low temperature in surgery?

Kim Buckley — Tue, 23 Nov 2010 23:02:30 GMT

Sorry to hear she didn't make it Sounds like you did everything you could though!

I have seen a cat with similar injuries except it ripped off most of the skin on it's abdomen. Required a lot of flushing and suturing and it did make it through the surgery but died a few days later due to massive infection. Sometimes you just can't do enough

Re: How do you recover a low temperature in surgery?

Emma Purnell — Tue, 23 Nov 2010 21:23:46 GMT

[quote user="dinkyd"]

Just a wee thing but may help - and you probably did it but also fluids that are used for flushing wounds warmed as well.

I have been taught as well that trying to keep the patient waem from as soon as pre med given - this seems to kick off the initial drop in temp and then added on to everything else as in your situation it can get very low.Sometimes no matter what you try they still become hypothermic- its quite a challenge!

[/quote]

Sorry, I meant to say, we had the flushing fluids in the same bowl that was heating the drip line and it was checked for warmth every 5 minutes and topped up from the kettle to the right temperature when needed.

We did i.v. premed it so I tried to keep it warm from then, it was a bit shocky still which didn't help, we tried to stabilise it first but could only leave it in that state so long.

Just very very sad, I wish I could have done more for her, poor sweetie.

Re: How do you recover a low temperature in surgery?

dinkyd — Tue, 23 Nov 2010 20:49:26 GMT

Just a wee thing but may help - and you probably did it but also fluids that are used for flushing wounds warmed as well.

Re: How do you recover a low temperature in surgery?

Phrin Vernon RVN — Tue, 23 Nov 2010 19:35:37 GMT

Awww - what a sad outcome

Sounds like you did all you could though.

Re: How do you recover a low temperature in surgery?

Emma Purnell — Tue, 23 Nov 2010 17:16:22 GMT

Really really sad. Its frustrating as well, we put it through so much yesterday and by this morning it was fussy, purring when fussy (not that comfort purring I hate so much) and eating happily, but after all that the back feet were already showing signs of problems and we were concerned about the viability of the skin flap we tacked back to cover its rear end. It was all bleeding yesterday, but nothing today. Have some awful photos taken in the hope we could map the improvement over time...

Lots of discussions over if we should have done the op in the first place, but if the owners want us to try...

All very sad. RIP little Georgie.

Re: How do you recover a low temperature in surgery?

Vicky RVN — Tue, 23 Nov 2010 15:02:45 GMT

Aww that's a sad outcome Sounds like you did everything you could though x

Re: How do you recover a low temperature in surgery?

Emma Purnell — Tue, 23 Nov 2010 13:11:41 GMT

It was a nightmare, and it had to be out so long. Temperature got right down to 34.3 degrees, we were really starting to panic at that point.

I had -

- pressure sensitive heat pad and blankets from the start

- bubblewrap on body and enclosing the legs (as much as possible)

- hot hands

- drip running through a hot water bath

- heaters in the room to warm the ambient temperature

- hair dryers on the cat in the end (not ideal in theatre but all wounds were dirty to start with and we were getting desperate!)

Cat recovered well from the surgery and temperature came back up ok after but obviously was in a LOT of pain. Just had the owners in, re-sedated the cat and made the decision to euthanase today. Very very sad.

Re: How do you recover a low temperature in surgery?

Kim Buckley — Tue, 23 Nov 2010 11:10:46 GMT

These cases are really hard to keep warm just because the amount of open area.

Ideally a bair hugger would be brill in these situations but I know these aren't an option in a lot of practies.

I would have just tried to keep as much of the cat covered with bubble wrap and blankets underneath the drapes. Also used "hot hands" or something along that line to try and warm the cat up.

Re: How do you recover a low temperature in surgery?

Vicky RVN — Tue, 23 Nov 2010 10:16:58 GMT

I tend to:

use a reflective mat on op table
warm i/v fluids