Question: Are you aware of any guidelines for use of warming blankets on medical-surgical patients?

Complete Question: Warming blankets such as the Bare Hugger are occasionally used to warm patients on our unit. I cannot find a recommendation on when and how to use this type of device on an inpatient unit. I would like to develop a protocol detailing temperature range and frequency of temperature checks in order to keep patients safe when this equipment is used. Are you aware of any guidelines for use of warming blankets on medical-surgical patients?

Answer: Many organizations queried do not use have a specific policy in regards to a warming device (Bair Hugger). Additionally, many of our queried members work in institutions that restrict this type of a device to the critical care areas such as ICU, ICU step-down, ED, and PACU, and are rarely seen in a medical-surgical unit.

However, when this device was seen, it was utilized for post-operative patients who needed assistance in maintaining a proper temperature. Typically, the provider would initiate an order in order to use the device on the unit and would dictate what the target temperature should be, and a Foley catheter that monitored temperature was used continuously.

Additionally, providers would also list using the manufacturer's directions as the basis for temperature regulation settings as the protocol.

One facility utilized the following protocol in their Medical-Surgical setting for the Bair Hugger:

  1. For long-term maintenance, a Low temperature (32.2C) was to be used.
  2. For Immobile of patients with poor circulation, a Medium temperature (37.8C) was to be used.
  3. Highly active patients who have normal circulation are to use the High temperature (43.3C) setting.

*Use with caution at low setting if patient has peripheral vascular disease, low cardiac output, or is totally immobilized.

**In the perioperative setting, for a post-anesthetic patient who is hypothermic, the following recommendation would be utilized: Apply the forced-air warming system, assess temperature every 15 minutes until normothermic, then every 1 hour.

The overall consensus was that the device in question is not one that is routinely utilized within the medical-surgical setting. However, if it is to be used, it is used on a case by case basis, and there needs to be a collaboration with the healthcare provider(s) in order to facilitate the appropriate temperature regulation for the individual.

Frequent assessment needs to commence, and the patient needs to be instructed to alert the nursing staff if there are any concerns with the use of the device.

(Published 2014)