Hypothermia Treatment Using Radiant Heat
Hypothermia
Critique of Postoperative Hypothermia Treatment Using Radiant Heat by Yang et al. (2012)
Critique of Postoperative Hypothermia Treatment Using Radiant Heat by Yang et al. (2012)
Perioperative hypothermia has been shown to increase the risk of post-surgery complications, thereby threatening the health of patients and increasing the cost of care (reviewed by Hooper et al., 2009). Guidelines for active warming measures have been suggested by a number of experts, which attempt to address the health risk perioperative hypothermia represents. Should patients arrive in the post-anesthetic care unit (PACU) in a hypothermic state, the conventional approach is to cover patients with pre-warmed hospital blankets; however, forced air-warming has been shown to be more effective across patient populations.
Yang and colleagues (2012) recently published the results of a study examining the relative efficacy of warmed blankets and a radiant heat source for achieving a normothermal state in the PACU. This report will examine all aspects of this study in detail and provide a critical analysis, thereby determining whether their findings are sufficiently rigorous to complement the existing evidence base supporting the implementing of active warming measures in the PACU.
Substantive and Theoretical Dimensions
Hypothermia has long been considered a significant health risk to postoperative patients (Pikus and Hooper, 2010); so much so that the American Society of PeriAnesthesia Nurses (ASPAN) issued formal guidelines in 1998 that have been updated as research findings have become available (Hooper et al., 2009). This continues to be an active area of research and therefore investigating the relative effectiveness of warm blankets and radiant heaters is clinically relevant. Should the researchers discover a better method of warming patients postoperatively, then the benefits to surgical patient outcomes could be significant. This explains why Yang and colleagues (2012) tracked the cost of care and hospital length of stay for patients enrolled in their study.
The use of radiant heaters is one method of many suggested by the ASPN, but forced air warming is considered the gold standard for perioperative treatment of hypothermia (Hooper et al., 2009). Yang and colleagues (2012) mentioned forced air warming as a common method for achieving normothermia in the PACU, but viewed this option as problematic because of the contamination issues such devices create. In countries with a relatively underdeveloped health care system, forced air warming may not be a viable choice because the devices require so much attention. Although not discussed directly by the authors, radiant heat would be one method of warming that would help minimize contamination risks and require little maintenance. The authors of this study may have also felt unconstrained to try methods they have experience with, since this research took place in Taiwan. Radiant heat is therefore a clinically relevant method for patient warming because it reduces the contamination risk of forced air warming and is more conducive to a care environment lacking the resources common to Western socities.
The research methods employed in this study are straightforward and directly address the question of whether radiant heat is more effective than warmed blankets for hypothermic postoperative patients. The primary outcome measure was changes in patient tympanic temperature. Therefore, the independent variables were warmed hospital blankets and radiant heat, while the dependent variable was tympanic temperature. The independent and dependent variables are directly relevant to the question being asked and have important clinical significance.
In framing their question, Yang and colleagues (2012) reviewed the relevant literature and presented the findings from selected studies in the introduction. Their introduction helped frame the research question being investigated sufficiently for the reader to easily comprehend both the rationale for the study and why the study needed to be performed. However, it was far from comprehensive. A recent multi-study review of postoperative warming techniques (Pikus and Hooper, 2010) was not cited, nor was several relevant studies mentioned in this review. In fact, the studies cited by Yang and colleagues (Giuffre et al., 1991 and Weyland et al., 1994) were not cited by Pikus and Hooper, and vice versa (Brauer et al., 2004 and Villamaria et al., 1997). Pikus and Hooper limited their analysis to studies conducted since the release of the ASPAN guidelines in 1998 and therefore would not have included the articles cited by Yang and colleagues; however a good explanation for why Yang and colleagues did not cite the same articles that Pikus and Hooper did is lacking. The literature review by Yang and colleagues is therefore missing at least two relevant studies that should have been discussed.
Methodological Dimensions
Wound Care Chronic wounds represent a devastating health care problem with significant clinical, physical and social implications. Evidence suggests that consistent, meticulous and skilled care provides the primary means by which successful wound care and healing is promoted. The occurrence of wounds has plagued humankind throughout recorded history and remains a major source of morbidity and mortality in several disciplines of clinical medicine. Within this thesis, an effort will be made
In this regard, the documentation should include the four main assessment components; which are, nutrition, wound etiology, wound appearance and pain (Assessment and Documentation Issues in Wound Care). In other words a careful written as well as visual record should be kept of all the possible factors and variables relating to the patient's condition and to the progression or otherwise of the healing process. There are two further reasons that are
This highlights the seriousness of the need for proper wound care in long-term care facilities, demonstrating the extent to which the nurse must define and provide oversight to standards in this area. What steps should be taken to ensure proper wound care? The first and most important aspect of ensuring that wound care is attended with proficiency is the provision of comprehensive training for nurse professionals. There are an array of
Certification for wound care are available but wound care is not typically addressed as an area of specialization for nurses. There is a corresponding lack of wound care training for nurses in key fields including those who work with diabetics. Research shows that proper wound care can minimize complications related to lack of mobility including bed sores, and reduce the rates of amputations. Comprehensive wound care training is therefore
Chronic Wound Care: Nursing Assessment And Intervention Chronic Wound Care: Nursing Assessment and Intervention Chronic Wound Care: Nursing Assessment and Intervention Chronic wounds are a challenge for both the clinician and the patient. For the nurse, issues of chronic wound care include the type of wound, the condition of the patient, and presence of infections, possible antibiotic therapy, and patient education on chronic wound care management. For the patient, issues revolve around how the
Wound Healing Quantitative Research Critique Vogt, Uhiyarik, & Schroeder (2007) conducted a study that compared Aquacel dressing vs. standard wound care for primary closed vascular surgical wounds. The results of the study found that there was no difference in length of stay in the hospital, complications, patient comfort, or healing time between the two wound care methods. The only difference was that the Aquacel dressing required fewer changes than conventional dressings, but
Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.
Get Started Now