Blanket Warmers Revisited And Temporal Thermometers

Abstract

I wrote about this in the January/February issue. While I noted that the ECRI Institute recommends that blanket warmers be set no higher than 130F, my explanation of other material on this issue was not clear. The ECRI Institute reached out to me about this, so I'd like to revisit my answer in the interest of patient safety.I had found another article online that concluded temperatures can be set as high as 200F. A key piece of information that I neglected to consider when passing on this information is that the article I looked at addressed the comfort of conscious patients. As patient safety advocates, we must consider what would happen to a patient who is unconscious (or a sensory compromised patient), and cannot verbalize that the blanket placed is too hot. We must also consider the very reason we are using a warmed blanket in the first place. We are not trying to raise the patient's core temperature, but we are trying to minimize the loss of body heat and therefore give the patient a feeling of comfort.Also, while The Joint Commission does not regulate temperature settings for blanket warmer cabinets, it does make note of the ECRI recommendation of 130F. Therefore, the best thing to do is to set those warming cabinets at 130F.ECRI's Mark Bruley, vice president of accident and forensic investigation, adds: “There are common misperceptions among clinicians and blanket warmer vendors about the thermodynamics of heat transfer, patient warming, and the onset of skin burns at moderate temperatures … A temperature of 200F, even in a fluffy blanket, certainly can burn patients. Burns to patients from cloth blankets heated to lower temperatures have done so when the blanket was not unfolded. There is no way to ensure the safe application of a blanket heated above 130F.”We do allow the use of temporal thermometers at our hospital in some areas. Biomedical technicians are not really in the business of making clinical decisions. It is my experience that clinical decisions should be left to clinical professionals. Of course, I am assuming you have the clinical staff to do the research as we have at my hospital. That being said, here is a quick synopsis of how the temporal thermometer works and why our hospital believes it can be used in certain areas.The temporal artery runs very close to the temporal area on the side of the head. This artery is very superficial, lying about 1mm below the skin. The fact that it is so superficial means that it conducts heat very easily to the surface of the skin. And since the artery does not branch off anywhere, the perfusion is high and stable which means the temperature will be more reliable than it might be at near other vessels. Infrared energy is used against a known constant to provide a temperature reading.Our hospital, after much research, has allowed the use of these thermometers in areas where temperatures are taken at a high volume and where there is also another type temperature being recorded at a longer interval. We use them as the recovery room and intensive care. We add them to inventory. We also check them periodically because if they are not cleaned the reading reliability drops markedly. We check them every six months because we have had a high corrective rate on these units. We also educate staff about the cleaning of these units.