tag:blogger.com,1999:blog-30499448.post3621665168793879441..comments2024-02-18T13:53:30.168-08:00Comments on Surgeonsblog: Cold ComfortSid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comBlogger21125tag:blogger.com,1999:blog-30499448.post-23533627660662893492011-06-28T15:42:46.615-07:002011-06-28T15:42:46.615-07:00Interesting. I had sugery a couple of months ago ...Interesting. I had sugery a couple of months ago and noticed that the OR was very cold when I was wheeled in. I actually liked it (I'm always on the warm side, anyway). They did put a warm blanket over me before knocking me out though. When I woke up in recovery I had no blankets and the nurse had removed my socks. She said I was very warm and sweating when I came out of surgery. Go figure.Lillyhttps://www.blogger.com/profile/02088068964411470878noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-9233096403747756292007-06-27T06:58:00.000-07:002007-06-27T06:58:00.000-07:00anon: you are right. Which is not to say the rules...anon: you are right. Which is not to say the rules are logical, of course: I refer to OHSA rules, by which (I might be wrong, but I don't think so) humidifiers are required to maintain a specified level. I know that to be the case at least for surgical centers.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-69526556399168795932007-06-26T23:58:00.000-07:002007-06-26T23:58:00.000-07:00Dr. Schwab, I've just found your blog and totally ...Dr. Schwab, I've just found your blog and totally love it. As a veterinary epidemiologist interested in surgical procedure (both animal and human) I was intrigued by when you mentioned that static charges could in theory spark an explosion of inhalational general anaesthetics . . . but I thought these agents like halothane have almost totally been removed from human surgery in the US and western Europe since the early 1990s as better agents that won't go boom came into being? So are static charges still a problem?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-26592073991006476752007-06-23T21:48:00.000-07:002007-06-23T21:48:00.000-07:00Barb!!! How great to hear from you!! I hope you ar...Barb!!! How great to hear from you!! I hope you are well; I miss reading you, I miss you. And yeah, that kind of heat is why I could never be a pediatric surgeon. <BR/><BR/>Thank you for surfacing, if only briefly. Give us a sign: are you well? I'm guessing you are, because I concluded long ago from your blog that you have it all...Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-53221816598415673572007-06-23T21:34:00.000-07:002007-06-23T21:34:00.000-07:00Don't forget about the burns theatres! 28+ degrees...Don't forget about the burns theatres! <BR/><BR/>28+ degrees celsius... ice vests that melt and drip condensation down your scrubs... perspiring brows... constant thirst with full bladders... heat induced lethargy... and a constant eye on the patient's temperature...Barbados Butterflyhttps://www.blogger.com/profile/08682551090528020034noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-51642485054321080882007-06-23T06:04:00.000-07:002007-06-23T06:04:00.000-07:00I haven't done an actual study, but from what I've...I haven't done an actual study, but from what I've seen in the past 11 years in vet med, most of our patients (who generally have plenty of fur that you'd think would keep them warm) drop their temp the most in the period between premedding and induction. There's nothing more lovely than to slap a bair hugger on them prior to draping, and see their body temp rise to normal while intra-op.The Ethical Misshttps://www.blogger.com/profile/05993683580508874162noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-67676441136761538962007-06-21T21:49:00.000-07:002007-06-21T21:49:00.000-07:00Hi Dr S. - I'm with Lynn and wondered but didn't ...Hi Dr S. - I'm with Lynn and wondered but didn't want to ask either. They sound like they were lovely girls.<BR/><BR/>Personally, I love the cold because I get hot too easily and then I am miserable.<BR/><BR/>I did notice how cold the pre-op and OR areas were. Of all the procedures I had last year, In May I woke up freezing in post-op and it felt like to my core. I needed more blankets and still was cold. It wasn't even my longest time in the OR, so I don't know why that happened.SeaSprayhttps://www.blogger.com/profile/07906503090688697222noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-64242884509093276582007-06-21T17:29:00.000-07:002007-06-21T17:29:00.000-07:00"Who are Lori and Shanti - the women whose headsto..."Who are Lori and Shanti - the women whose headstones are on your front page?"<BR/><BR/>I'm so glad Anon asked. I've long wondered about who they were as well but was too chicken to ask for fear of being rude. How terrible to lose people so young and full of life. Please accept my heartfelt sympathies, Sid.Lynn Pricehttps://www.blogger.com/profile/02958402288888144904noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-91164290422843685992007-06-21T14:40:00.000-07:002007-06-21T14:40:00.000-07:00After my last surgery I told my old trauma surgeon...After my last surgery I told my old trauma surgeon that I'm surprised surgeons don't wear snow-suits to work!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-10432431609035726312007-06-21T14:29:00.000-07:002007-06-21T14:29:00.000-07:00My sole experience with ORs is for c-sections. An...My sole experience with ORs is for c-sections. And though I did notice the cold, I was brought up on the theory that it reduces infection, so it did not seem unusual to me, and in all honesty it was the least of my concerns both times. (Not emergency sections, but I wasn't happy about it either time.) I only got shivery in the recovery room after the second one.Sabrahttps://www.blogger.com/profile/13746486966764162127noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-82627226711152692802007-06-21T12:18:00.000-07:002007-06-21T12:18:00.000-07:00Anonymous: thank you for asking. You're the first ...Anonymous: thank you for asking. You're the first to comment. I could describe them in volumes. Lori is my brother's daughter; Shanti, the daughter of my wife's sister. Each was an amazing young woman, the kind that everyone felt was their best friend; the kind that made everyone happy to be around. They were each amazingly beautiful; head-turning. Each exuded a love of life and of the people in their lives to an extent far beyond the norm. They each died in their twenties, suddenly, unexpectedly, leaving their families devastated. An accident, a blood clot. I could go on without end.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-39639168580966379672007-06-21T12:03:00.000-07:002007-06-21T12:03:00.000-07:00Dr. Schwab,I'm new to your blog. If this informat...Dr. Schwab,<BR/><BR/>I'm new to your blog. If this information is posted somewhere else, I couldn't find it. Who are Lori and Shanti - the women whose headstones are on your front page?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-81494320696051009362007-06-20T19:31:00.000-07:002007-06-20T19:31:00.000-07:00There are many compelling reasons to keep the OR w...There are many compelling reasons to keep the OR warm and to actively warm the patient well during surgery.<BR/>A few really important ones include hypothermia-induced coagulopathy and subsequent bleeding, and increased oxygen consumption with postoperative shivering (not desirable in the fragile 80 year old with coronary artery disease).<BR/>I know a surgeon who wears a special vest while scrubbed, which circulates cold water through a system of tubes attached to the vest...I wonder if it's patented...Dr. H.https://www.blogger.com/profile/00249908560561016864noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-11965329131697781462007-06-20T13:42:00.000-07:002007-06-20T13:42:00.000-07:00Yeah, something about having one's abdomen ratchet...Yeah, something about having one's abdomen ratcheted open in a cold room doesn't do well for one's internal thermostat. I thought it was the coolest thing (ha, punny!) that the anesthesiologists use insulating socks for the IV fluid bags, too.<BR/><BR/>I don't think anybody who's been truly suited up in the OR could stand anything less what the normally-attired person would consider frigid. I am, unfortunately, an easy "sweater."Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-85786373740668416972007-06-20T13:25:00.000-07:002007-06-20T13:25:00.000-07:00They even have ones for little babies that go unde...They even have ones for little babies that go under the baby for surgeries on the little ones.dr. nichttps://www.blogger.com/profile/16105395433638027298noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-9595798443376641532007-06-20T11:10:00.000-07:002007-06-20T11:10:00.000-07:00The warmers have very many differnt names, Bair Hu...The warmers have very many differnt names, Bair Huggers, snuggle, equator. In some of the OR rooms they have water warmers and coolers. Most of them do not break that much.<BR/><BR/>They only problem is most have wheels and are hard to find for preventive maintenance. That and some night nurses like to use them to keep warm.Michelle in Colorado Springshttps://www.blogger.com/profile/16885115285183464185noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-13517209131595601402007-06-20T10:55:00.000-07:002007-06-20T10:55:00.000-07:0070F must be very warm in the OR. The link below se...70F must be very warm in the OR. The link below seems to suggest some like it much colder.<BR/><BR/>http://theunderweardrawer.blogspot.com/2007/04/even-though-i-did-embark-on-this-posts.htmlPetrihttps://www.blogger.com/profile/05883536086094218238noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-23429865931088178742007-06-20T10:23:00.000-07:002007-06-20T10:23:00.000-07:00I like the OR room cold too, but the patient's los...I like the OR room cold too, but the patient's lose a lot of heat by having the room below 70 degree (if the OR time is greater than one hour). There is a great article on the hypothermia patients often get and how to prevent it (Prevention of Perioperative Hypothermia in Plastic Surgery by V Leroy Young, MD and Maria Watson, MD; Aesthetic Surgery Journal, Sept/Oct 2006, pp 551-571). The minimum OR temperature recommended is 22 degrees Celcius (71.6 degrees F). I know to us surgeons that feels very warm. I now try to keep the room at least at 70, and then just roll up my scrub pant legs (heh, cropped pants are in, at least for us females)rlbateshttps://www.blogger.com/profile/15236331355857884458noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-88294643885269086032007-06-20T09:54:00.000-07:002007-06-20T09:54:00.000-07:00judy: we get around that by having a separate resu...judy: we get around that by having a separate resuscitation room for the tiny premies. Also, they're starting to put the smallest babies in baggies now to stop heat and water loss. <BR/><BR/>We wear the knee high boots (you know, the ones the orthopods wear) in addition to water proof gowns, hats, etc. and I am often dripping in sweat by the end, even though they do try to keep it cool.Midwife with a Knifehttps://www.blogger.com/profile/04309579302399381913noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-70573803219043230802007-06-20T07:51:00.000-07:002007-06-20T07:51:00.000-07:00That works everywhere except the C-section OR's wh...That works everywhere except the C-section OR's where the OB types are constantly battling the NICU crowd. Yes, we're roasting under the warmer, so chilling the room would be nice, but we have to think about the baby - for whom that blasting heat often isn't enough. <BR/><BR/>Good thing C-sections are relatively short surgeries. <BR/><BR/>OTOH, if I'm having surgery myself, I sure don't want the surgeon passing out from the heat and I'd rather not freeze while I'm sleeping - so great solution in the main ORs.Judyhttps://www.blogger.com/profile/08237756183010257014noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-90642388193028632202007-06-20T07:31:00.000-07:002007-06-20T07:31:00.000-07:00I'm quite disappointed that they don't appear to b...I'm quite disappointed that they don't appear to be actually bear-shaped.Joy K.https://www.blogger.com/profile/06200194467024962551noreply@blogger.com