Hyperthermia-Hypothermia Blanket Use
A blanket-sized aquamatic K pad, the hyperthermia-hypothermia blanket raises, lowers, or maintains body temperature through conductive heat or cold transfer between the blanket and the patient. It can be operated manually or automatically.
In manual operation, the nurse or doctor sets the temperature on the unit. The blanket reaches and maintains this temperature regardless of the patient’s temperature. The temperature setting must be adjusted manually to reach a different setting. The nurse monitors the patient’s body temperature with a conventional thermometer.
In automatic operation, the unit directly and continually monitors the patient’s temperature by means of a thermistor probe (rectal, skin, or esophageal) and alternates heating and cooling cycles as necessary to achieve and maintain the desired body temperature. The thermistor probe also may be used in conjunction with manual operation but isn’t essential. The unit is equipped with an alarm to warn of abnormal temperature fluctuations and a circuit breaker that protects against current overload.
The blanket is used most commonly to reduce high fever when more conservative measures—such as baths, ice packs, and antipyretics—are unsuccessful. Its other uses include maintaining normal temperature during surgery or shock; inducing hypothermia during surgery to decrease metabolic activity and thereby reduce oxygen requirements; reducing intracranial pressure; controlling bleeding and intractable pain in patients with amputations, burns, or cancer; and providing warmth in cases of mild to moderate hypothermia.
Equipment
Hyperthermia-hypothermia control unit ▪ fluid for the control unit (distilled water or distilled water and 20% ethyl alcohol) ▪ thermistor probe (rectal, skin, or esophageal) ▪ patient thermometer ▪ one or two hyperthermia-hypothermia blankets ▪ one or two disposable blanket covers (or one or two sheets or bath blankets) ▪ lanolin or a mixture of lanolin and cold cream ▪ adhesive tape ▪ towel ▪ sphygmomanometer ▪ gloves and gowns, if necessary ▪ Optional: protective wraps for the patient’s hands and feet.
Disposable hyperthermia-hypothermia blankets are available for single-patient use.
Preparation of Equipment
First, read the operation manual. Inspect the control unit and each blanket for leaks and the plugs and connecting wires for broken prongs, kinks, and fraying. If you detect or suspect malfunction, don’t use the equipment.
Review the doctor’s order, and prepare one or two blankets by covering them with disposable covers (or use a sheet or bath
blanket when positioning the blanket on the patient). The cover absorbs perspiration and condensation, which could cause tissue breakdown if left on the skin. Connect the blanket to the control unit, and set the controls for manual or automatic operation and for the desired blanket or body temperature. Make sure the machine is properly grounded before plugging it in. Turn on the machine and add liquid to the unit reservoir, if necessary, as fluid fills the blanket. Allow the blanket to preheat or precool so that the patient receives immediate thermal benefit.
blanket when positioning the blanket on the patient). The cover absorbs perspiration and condensation, which could cause tissue breakdown if left on the skin. Connect the blanket to the control unit, and set the controls for manual or automatic operation and for the desired blanket or body temperature. Make sure the machine is properly grounded before plugging it in. Turn on the machine and add liquid to the unit reservoir, if necessary, as fluid fills the blanket. Allow the blanket to preheat or precool so that the patient receives immediate thermal benefit.
Implementation
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.4
If the patient isn’t already wearing a hospital gown, ask him to put one on. Use a gown with cloth ties rather than metal snaps or pins to prevent heat or cold injury.
Assess the patient’s condition and explain the procedure to him. Provide privacy and make sure the room is warm and free from drafts.
Take the patient’s temperature, pulse, respirations, and blood pressure to serve as a baseline, and assess his level of consciousness, pupil reaction, limb strength, and skin condition.
Keeping the bottom sheet in place and the patient recumbent, roll the patient to one side and slide the blanket halfway underneath him, so its top edge aligns with his neck. Then roll the patient back, and pull and flatten the blanket across the bed. Place a pillow under the patient’s head. Make sure the patient’s head doesn’t lie directly on the blanket because the blanket’s rigid surface may be uncomfortable and the heat or cold may lead to tissue breakdown. Use a sheet or bath blanket as insulation between the patient and the blanket. (See Using a cooling system.)
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