Effectiveness Of Forced-air Warming (FAW) Blankets Vs. Warmed Cotton Blankets In Reducing Perioperative Hypothermia

PICO Process

Database used to source the article/academic resource: – should be a different database for each entry.

For searching the research article in this context, the databases which were used are PubMed, CINAHL, NCBI, and BMC nursing. 

Type of study and level of evidence: 

Yin et al., (2022): Prospective Randomized Study, Level 1 evidence.

Thapa, H. P., Kerton, A. J., & Peyton (2019): Randomized controlled trial. Level 1 evidence.

Min et al. (2018): Randomized controlled trial. Level 1 evidence.

Conway et al. (2018): Randomized controlled trial. Level 1 evidence.

Ethical Approval: State whether the article/resource required ethical approval? Yes/No – if yes, was it clearly stated in the article/resources? If no, why not? 

In the research conducted by Yin et al., (2022), Thapa et al. (2019), Min et al. (2018):Conway et al. (2018), it was found that the all the researchers acquired the informed consent from the participants before proceeding with the research that maintained the ethical integrity. 

Justification paragraph using the five components:  ARCOC - Authority, Relevance, Coverage, Objectivity, and Currency. Yin et al., (2022):

The first article selected in this study is published by Yin, W., Wan, Q., Jia, H., Jiang, X., Luo, C., & Zhang, L. In this article the author mainly focused on Forced-air warming (FAW) method’s effectiveness in preventing the inadvertent perioperative hypothermia (IPH) which is directly related to the research question. The researchers carried out the research on 100 patients those unerwent elective arthroscopic shoulder surgery. From the beginning of anaesthesia through the conclusion, the patients' body temperatures were monitored. The occurrences of hypothermia and shivering after surgery were also recorded. The researchers stated that, the temperature of the body of the participants was controlled and significantly lowered and it was found that When underbody FAW blankets were placed over patients, the temperature was much higher than when they were placed under them. The frequency of postoperative hypothermia was also substantially reduced, according to the researchers. Furthermore, they determined that using underbody FAW blankets over patients who underwent arthroscopic shoulder surgery is indicated for preventing IPH. From the aspect of currency it can be stated that, the research article was published in 2022 and very much current that can give the proper idea a nd a valid result which will be clinically relevant.   Thapa, Kerton, & Peyton (2019)

This article was published by Thapa, H. P., Kerton, A. J., & Peyton, P. J. (2019), who worked in Austin Hospital’s department of Anaesthesia, located in Melbourne, Victoria, Australia.  The researchers stated that at present the forced-air warming (FAW) blanket is one of the popular modality whereas they also included the use of EasyWarm self-heating  blankets. In this study, the researchers carried out a randomized controlled trial (singlecentre) in preventing intraoperative hypothermia for comparing the efficiency of the self-heating blanket EasyWarmVR with the a conventional FAW blanket which was also the focus of the PICO question. The 39 participants were divided into 2 groups where 19 used EasyWarmVR, whereas 20 used FAW blanket. The researchers used statistical analsysis and the findings supported the fact that EasyWarmVR offered additional benefits that FAW blanket and is equally capable to prevent the intraoperative hypothermia while comparing with Cocoon FAW blanket. From that aspect, it can be said that FAW blanket and Cotton blanket both can be given to the patients for preventing perioperative hypothermia. From the aspect of currency, it can be seen that the research was publsihed 3 years ago in 2019 and from that aspect it enhanced the practical applicability and the relevance of the research. Min et al. (2018):

Identified Research Studies

The author of this research were Min, S. H., Yoon, S., Yoon, S. H., Bahk, J. H., & Seo, J. H. (2018), who worked in Department of Anaesthesiology and Pain Medicin located in Republic of Korea. The researchers stated that forced-air warming (FAW) is very much efficient on the portion of lower body compared to the upper body in preventing the intraoperative hypothermia in the supine position. The researchers compared the use of FAW on the lower and upper bodies in the lateral position. In that research the researchers included a total of 123 patients and they divided the patients into 2 groups where effect of FAW blankets on upper as well as lower body was measured. The researchers discovered that warming in upper body was less common than  warming in the lower body, in preventing hypothermia throughout thoracoscopic surgery in the lateral decubitus position, as well as forced-air warming was more successful or applicable on the upper body compared to the lower body in preventing hypothermia. The result can be very relavant to the research study and preferred the used intervention of the PICO question. The research was published in 2018, which is within 5 yers from now and is very much cuurent. Conway et al. (2018):

The last article slected in this context was published by Conway, A., Ersotelos, S., Sutherland, J., & Duff, J. (2018), where most of the researchers practice in different hospital settings in Queensland Australia. The major objective of the study stated that, throughout general anaesthesia, forced air warming (FAW) is indeed an efficient and safe way to prevent hypothermia. The goal of this research was to see if using FAW for sedation-assisted treatments in the cardiac catheterization laboratory reduced hypothermia. In the research, the researchers carried out a randomised controlled trial among parallel-group. The researchers measured shivering, postprocedure temperature, thermal comfort as well as main complications, which is also a major focus of the PICO question. The researchers stated that, FAW significantly decrease the hypothermia as well as enhance the thermal comfort. Moreover, the complication was also very less in FAW use that more precisely answere the PICO question. Moreover, the research was published in 2018, which is within 5 yers from now and is very much cuurent that enahcne the bvalidity of the research and might help the researchers and readers to get the recent and relevant application of that intervention. 

Reference 

Yin, W., Wan, Q., Jia, H., Jiang, X., Luo, C., & Zhang, L. (2022). Comparison of Two Different Uses of Underbody Forced-air Warming Blankets for the Prevention of Hypothermia in Patients Undergoing Arthroscopic Shoulder Surgery: a Prospective Randomized Study. DOI: 10.1186/s12871-022-01597-6

Thapa, H. P., Kerton, A. J., & Peyton, P. J. (2019). Comparison of the EasyWarm® self-heating blanket with the Cocoon forced-air warming blanket in preventing intraoperative hypothermia. Anaesthesia and intensive care, 47(2), 169-174. https://doi.org/10.1177%2F0310057X19840264

Min, S. H., Yoon, S., Yoon, S. H., Bahk, J. H., & Seo, J. H. (2018). Randomised trial comparing forced-air warming to the upper or lower body to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position. British journal of anaesthesia, 120(3), 555-562. https://doi.org/10.1016/j.bja.2017.11.091

Conway, A., Ersotelos, S., Sutherland, J., & Duff, J. (2018). Forced air warming during sedation in the cardiac catheterisation laboratory: a randomised controlled trial. Heart, 104(8), 685-690. doi:10.1136/heartjnl-2017-312191

Write a reflection on the use of the PICO framework. Please consider the following points in your reflection:

1. What were your challenges and successes when using the PICO framework to develop your systematic search for evidence?
2. How can the PICO framework assist you to ensure that your clinical nursing decisions are based on the best available evidence? 

While carrying out this evidence-based practice this PICO framework helped me greatly as it shaped the structure of the evidence based research and helped me to formulate the search terms and how to carry out the search in the databases. The comparison method and way Of comparing between two intervention became very easy for me because of this PICO framework. PICO makes this a lot easier. This is a shortened version of the core components of a clinical question which is well-crafted. It also supports in the creation of a search strategy by mentioning the primary subjects that should be covered for answering the question. However, finding out the articles and reviewing the articles and go thorugh it was never easy and I found the development of synonnyms of the search terms very challenging.  Moreover, the literature search and the evidences search that were done by PICO format significantly helped me to make decisions about the intervention as thye majority of the articles supported the use of Forced-Air-warming and guided the usage of the FAW blanket among the patient with perioperative hypothermia. Furthermore, the evidences helped me a lot by guiding how to carry out research in future practice when the decision-making process would required evidence-based-support.