The Alternative Use of a Patient Warming Device as a Patient Cooling Device

Abstract

To the Editor: We would like to report on an alternative use for the Bair Hugger Registered Trademark Patient Warming System (Augustine Medical Inc., Eden Prairie, MN), a temperature-controlled, forced-air patient warming device. During a recent carotid endarterectomy performed under regional anesthesia, the patient complained of being too warm and uncomfortable, asking for "more air." The surgical drapes were removed as far as possible but still remained close to the patient's face. The room temperature was decreased. Continuous fanning with the anesthetic record by the anesthesiologist provided temporary relief of the patient's symptoms, but, owing to an (un)expectedly long operating time and fan-operator fatigue, it was impossible to maintain adequate turbulent airflow for patient satisfaction. A quick visual scan of the operating room revealed an unused Bair Hugger Registered Trademark warming unit, which was immediately converted to a cooling unit by using the nondisposable air hose to supply a fresh air current to the patient, with the unit's temperature control set on "ambient temperature." The patient enjoyed the remainder of the operation in perfect climatic conditions, and the anesthesiologist's hands were freed to perform more standard duties. Most importantly, this notable improvement in patient care incurred no extra cost to the patient, the hospital, or any third-party payer. In these days of cost containment and managed care reforms, we propose further investigations into alternative uses of expensive and underutilized equipment. Do autoclaves steam vegetables? Burkhard F. Spiekermann, MD Thomas S. McDowell, MD, PhD Department of Anesthesiology, University of Virginia Health Sciences Center, Charlottesville, VA 22908