Conduction is the most common type of active warming and comes in different forms [ 9 ] , including heat pads , Bair Huggers and hot water bottles . Best practice would be to prevent a reduction in temperature by providing a heat source at the time of anaesthesia induction . This would help to reduce the discrepancy between admission and discharge temperatures .
Warming devices are routinely used for other procedures , so resources are readily available in practice without having to incur extra costs associated with purchasing additional specific warming aids . Handheld oxygen saturation , capnography and blood pressure monitoring machines are also used routinely . A multiparameter monitor with an oesophageal temperature probe would be the ideal method of temperature monitoring as this provides a core temperature . However , the practice does not have a multiparameter machine and purchasing a monitor would be a considerable expense to accommodate the use of an oesophageal temperature probe .
A Standard Operating Procedure ( SOP ) can be created , and this can be discussed at the next practice meeting . This SOP should include the introduction of a flat heat pad and blanket , so the patient is not making direct contact with the radiography table . The heat pad and blanket can be placed at the cranial end of the patient , where anaesthesia induction will take place and will provide a warm barrier between the anaesthetised patient and the cold radiography table .
It is also important that radiography positioning training takes place more frequently in practice . This will ensure a reduction in the number of radiographs taken , creating a safer working environment ( in line with IRR17 ), and will also enable a shorter anaesthetic time for the patient as diagnostic images will be obtained more quickly .
Conclusion
Although the patients in this audit were not considered to be clinically hypothermic , there was a substantial and avoidable reduction in body temperature due to inadequate patient warming from the point of anaesthesia and during the radiography procedure .
Future considerations for audits would include repeating this audit with the heat source added . This audit could be extended to include radiography of other areas of the body ( e . g . limbs , thoracic and abdominal views , and the spine ). It could also be considered for other diagnostic procedures , including ultrasonography and endoscopy , and used to monitor different species during a diagnostic imaging process .
Acknowledgements
With thanks to Alexandra and Hillyfields Vets , Green Pastures Vets and Rata Vet Surgery .
REFERENCES
1 Baker MA . An introduction to radiation protection in veterinary radiography . The Veterinary Nurse . 2014 ; 5 ( 9 ): 496 – 501 .
2 Mackenzie D . Module 5 : Imaging . Radiography Basics , Patient Positioning . Nurse Certificate in Surgical Nursing . 2015 . p . 2 – 4 .
4 Grint N . Module 3 : Anaesthesia , Monitoring of Anaesthesia . Nurse Certificate in Surgical Nursing . 2021 . p . 28 .
6 MacPherson GC , Allan GS . Osteochondral lesion and cranial cruciate ligament rupture in an immature dog stifle . Journal of Small Animal Practice . 1993 ; 34 ( 7 ): 350 – 352 .
8 Morgan JP , Silverman S , Zontine WJ . Techniques of Veterinary Radiography . 5th ed . Ames : Iowa State University Press ; 1993 .
10 Holden D ( 1999 ) Postoperative care . In : Seymour C , Gleed R . ( eds .) Manual of Small Animal Anaesthesia and Analgesia . Gloucester : British Small Animal Veterinary Association ; 1999 . p . 17 .
13 Johnson C . Patient monitoring . In : Seymour C , Gleed R . ( eds .) Manual of Small Animal Anaesthesia and Analgesia . Gloucester : British Small Animal Veterinary Association ; 1999 . p . 44 .
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34 Veterinary Nursing Journal