Skill 31
Hypothermia and Hyperthermia Blankets
A hypothermia-hyperthermia blanket raises, lowers, or maintains body temperature through conductive heat or cold transfer between the blanket and the patient. When placed on top of a patient, the blanket helps to raise or lower the patient’s body temperature (Fig. 31-1). When operated manually, the unit maintains a preset temperature regardless of the patient’s temperature. When operating in the automatic setting, the unit continually monitors a patient’s temperature with a thermistor probe (rectal, skin, or esophageal). The system increases or decreases the temperature of the circulating water in response to the preset target temperature and actual measured patient temperature.
Fig. 31-1 Hypothermia cooling blanket is applied over paper sheet before additional top sheet is applied to bed. (Courtesy Cincinnati Sub-Zero Maxi-Therm Hyper-Hypothermia Blanket.)
Recent research shows that induced hypothermia prevents or moderates neurological outcomes after neurosurgery or during traumatic brain injury and acute stroke (Fox et al., 2010; Linares and Mayer, 2009; Polderman, 2008; Polderman and Herold, 2009). Mild hypothermia (32° to 34° C [89.6° to 93.2° F]) in the first hours after an ischemic event and for 72 hours or until stabilization occurs helps prevent permanent damage (Fox et al., 2010).
Delegation Considerations
The skill of applying a hypothermia or hyperthermia blanket can be delegated to nursing assistive personnel (NAP) (see agency policy). The nurse is responsible for assessing and evaluating treatment and related patient education. If the patient is unstable and at risk for complications, this skill is not delegated. The nurse directs the NAP to:
▪ Inform the nurse of any unexpected patient outcomes (e.g., shivering or redness to the skin).
▪ Report when treatment is complete so an evaluation of the patient’s response can be made.
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