Karen, a 35-year-old, is admitted to theatres for laparoscopic appendectomy under general anaesthesia. Her pre-operative temperature was 35 degree Celsius and on arrival to theatres, she verbalised ‘feeling extremely cold’. The plan is to position the patient in the supine position for surgery and to provide active warming on the patient.

Looking at the case scenario and NICE clinical guidelines (CG65), how would you assist and support in the care of the patient to prevent a) inadvertent perioperative hypothermia and b) positioning related injuries.

NICE guideline to use for active patient warming throughout the patient’s surgical pathway:  bair hugger, warm intravenous fluids and blood products, use warmed prep solutions/irrigation fluids, do not expose the patients unnecessarily, monitoring patient’s body temperature. Keep ambient temperature at minimum of 21°C in theatres until active warming is established.

For the prevention of positioning injuries: use gel paddings on bony prominences. Keep body in alignment and anatomical position. Do not pull/drag the patient during transfer. Use sliding sheets or pad slide. Coordinated movement of both limbs. Avoid over-stretching the neck. Do not hyperabduct the arms on the arm board (no more than 90 degrees).