- warming blankets such as the Bair HuggerTM
- aka patient warming system
- May be indicated if temperature <35°C
- warmed air is blown over the patient allowing safe and effective heat distribution
- may be attached to an IV pole or be free standing
- wide range of blanket shapes and sizes
- typically consists of a silky polyester fabric with an inlay of nylon waterproof material to keep airflow circulating up towards the patient
- Blankets can be used with all major brands of warm air convection units.
- All warming units regulate the air temperature at the end of the delivery hose and have audible and visual over temperature alarms.
- A fluid/blood warming system is now available that utilises Bair Hugger hose for warming (Bair Hugger 241); meaning two warming modalities are available from the same equipment
METHOD OF USE
- Patient is covered with blanket and the hose inserted into the designated hole
- Need to ensure that it is securely connected and no air is escaping
- Hose is kept straight as excessive bends affect temperature performance
- Blanket is inflated and checked for air leakage
- Low/medium/high settings chosen according to the patient’s temperature
- Extra blankets should not be placed over the Bair HuggerTM as this can lead to uneven heat distribution
- Head should always be covered as this route may account for up to 50% of heat loss
- Overwarming and complications of hyperthermia
- Impaired detection of clinical signs (e.g. cyanosis, external bleeding)
Concepts of heat transfer
- Heat is the thermal energy created by the movement of atoms and molecules within a substance that may be transferred from one system of atoms/molecules to another
- Radiation (main mechanism) – energy transferred by electromagnetic (infrared) waves from a surface
- Convection – energy transferred to air or liquid flowing past a surface
- Evaporation – energy is lost as fluid on a surface is converted to gas
- Respiration – energy is lost in exhaled humidified gas from the lungs
- Conduction (least important mechanism) – energy is directly transferred between two surfaces in direct contact
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC