October 25, 2002
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Perianesthesia nursing guideline for thermoregulatory management endorsed by the American Society of Anesthesiologists

American Society of PeriAnesthesia Nurses (ASPAN) announces key endorsement

Cherry Hill, NJ (October 25, 2002) —The American Society of Anesthesiologists (ASA) Committee on Surgical Anesthesia “has reviewed, and approved” ASPAN’s Clinical Guideline for the Prevention of Unplanned Perioperative Hypothermia according to Roger W. Litwiller, M.D., first vice president, ASA. The guideline was developed at a multi-disciplinary consensus conference sponsored by ASPAN, and was originally published in the October 2001 Journal of PeriAnesthesia Nursing.1

Endorsement was granted at ASA’s annual meeting held in October 2002. “ASPAN is very pleased to announce this endorsement by ASA along with similar endorsements by AANA [American Association of Nurse Anesthetists] and AACN [American Association of Critical Care Nurses], among others. This action validates the significance of ASPAN’s Hypothermia Guideline,” said Kevin G. Dill, ASPAN CEO.

“The prevalence and consequences of inadvertent perioperative hypothermia can no longer be underestimated. The time has come for definitive guidelines addressing the management of the problem,” said Linda Wilson, PhD, RN, CPAN, CAPA, BC, ASPAN president.

Despite the availability of technology, the prevention of inadvertent hypothermia remains an ongoing problem in the perioperative period. Every patient undergoing surgery is at risk for developing hypothermia.2 This guideline is designed to explore the physiological basis for hypothermia; cite clinical studies linking perioperative hypothermia to adverse outcomes and improve patient outcomes. Published research has correlated significant adverse consequences, such as impaired wound healing, cardiac events, altered drug metabolism and coagulopathies with inadvertent perioperative hypothermia. With prevention and management of hypothermia, patients experience a greater level of comfort and avoid postoperative shivering and the unpleasant sensation of feeling cold. In addition, meta-analysis results demonstrate that hypothermia averaging only 1.5°C below normal causes cumulative adverse outcomes that may add $2500 to $7000 per surgical patient to hospitalization costs.3 Significant factors associated with elevated costs of patient care include increased length of stay, increased need for blood component therapy, increased need for mechanical ventilation, and increased adverse cardiac events such as myocardial ischemia (chest pain/unstable angina) and ventricular tachycardia (a lethal arrhythmia). In 1989, legislation that created the Agency for Health Care Policy and Research (AHCPR) called for the development, periodic review and update of clinically relevant guidelines.

In response to this legislation, ASPAN is the first nursing specialty organization to initiate the development of a clinical guideline for perioperative hypothermia management. ASPAN sponsored a Consensus Conference on Perioperative Thermoregulation that brought together participants from across the healthcare spectrum. The guideline is the culmination of the consensus conference and the interdisciplinary development panel. Daniel I. Sessler, M.D. and Henry Rosenberg, M.D., two pioneering researchers in the field of anesthesia and its effects on temperature management in the perioperative setting, were among the many distinguished contributors to the development of the Hypothermia Guideline. The ASPAN guideline was designed to serve as a bedside tool for clinicians to use in the prevention and management of unplanned perioperative hypothermia. The guideline has five goals:

  • Establish a definition for normothermia: 36°C-38°C (96.8°F-100.4°F)
  • Establish a definition for hypothermia: Temperature less than 36°C (96.8°F)
  • Alert healthcare providers in perioperative settings of the importance of maintaining perioperative normothermia.
  • Address the management of unplanned perioperative hypothermia.
  • Improve patient outcomes by establishing strategies to maintain perioperative normothermia.

In addition, ASPAN hopes that this initiative will promote further guideline development and research related to the prevention of hypothermia, specifically for pediatric and trauma patients and temperature measurement and monitoring. About ASPAN ASPAN represents the interest of over 40,000 perianesthesia nurses throughout the United States and across the globe. The mission of the society is to advance nursing practice through public and professional education, research and standards of practice.

For information contact ASPAN
877-737-9696, ext. 15

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