Active warming used intraoperatively for the purpose of maintaining normothermia, or at least 1 body temperature equal to or greater than 36 degrees Centigrade (or 96.8 degrees Fahrenheit) recorded within the 30 minutes immediately before or the 15 minute
CPT4 code
Name of the Procedure:
Active Warming (Intraoperative Normothermia Maintenance)
Summary
Active warming is a technique used during surgery to keep a patient's body temperature at 36 degrees Centigrade (96.8 degrees Fahrenheit) or higher. This method is applied either 30 minutes before surgery begins or within the first 15 minutes of the operation to prevent drops in body temperature.
Purpose
Active warming is employed to prevent hypothermia during surgery, which can lead to complications such as increased blood loss, infections, and longer hospital stays. The main goal is to maintain normothermia, ensuring the patient’s body temperature remains stable throughout the procedure.
Indications
- Major surgeries longer than 60 minutes
- Patients with pre-existing conditions affecting thermoregulation
- Individuals with low body fat or at higher risk of hypothermia
- Pediatric and geriatric patients who are more susceptible to temperature fluctuations
Preparation
- Pre-surgery instructions may include fasting as directed by the surgeon.
- The patient may be advised to wear minimal clothing under their hospital gown.
- Preoperative assessments to monitor baseline body temperature.
Procedure Description
- Initial Setup: Specialized warming devices like forced-air warming blankets or warming pads are prepared.
- Application: The warming device is positioned to cover exposed areas of the patient's body.
- Monitoring: Continuous temperature monitoring using a thermometer or temperature probes ensures the patient's temperature stays within the target range.
- Adjustment: The warming device settings are adjusted as needed based on real-time temperature readings.
Tools and Equipment:
- Forced-air warming blankets
- Circulating-water mattresses
- Intravenous fluid warmers
- Temperature monitoring devices
Anesthesia/Sedation: Typically, patients will already be under general anesthesia for the surgical procedure.
Duration
The active warming process starts 30 minutes before the surgery or within the first 15 minutes and continues throughout the procedure for as long as necessary.
Setting
Active warming is performed in an operating room within a hospital or surgical center.
Personnel
- Surgeons
- Anesthesiologists
- Operating room nurses
- Surgical technologists
Risks and Complications
- Burns or skin irritation from warming devices
- Overheating if devices are not monitored properly
- Rare allergic reactions to materials in warming devices
Benefits
- Reduced risk of surgical site infections
- Lowered blood loss during surgery
- Shorter recovery times
- Improved overall surgical outcomes
Recovery
- Continuous monitoring of body temperature may be required postoperatively.
- Specific post-op instructions will be given, including when normal activities can be resumed.
- Follow-up appointments to ensure proper recovery.
Alternatives
- Passive warming methods, such as using warmed blankets (less effective for major surgeries).
- Pre-warming the operating room (may not be as efficient).
Pros and Cons:
- Active Warming: More effective in maintaining stable body temperature, but requires specialized equipment.
- Passive Methods: Easier to apply but less effective in preventing intraoperative hypothermia for prolonged or major surgeries.
Patient Experience
- The patient will be under anesthesia and won't feel the procedure.
- Postoperatively, they may feel slightly warmer or have areas of redness from warming devices, which are generally managed with standard post-surgical care.
- Comfort measures and pain management will be provided according to post-surgical protocols.