Tag Archives: normothermia

Jun 28, 2018

3M Science at APIC 2018

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3M Science at APIC 2018The biggest infection prevention conference of the year, the 45th APIC Annual Conference, was held last week right in 3M’s backyard of Minneapolis, Minnesota. We were excited to be part of the movement to advance the infection prevention efforts of facilities across the country and to help clinicians move toward reducing rates of preventable infections.

Breakfast Symposium: Reducing the Risks of CLABSI and SSI

On Friday morning, 160 APIC attendees gathered for a symposium on “Reducing the Risks of CLABSI and SSI: What Is the Evidence?” Mark Rupp, M.D., professor and chief of the division of Infectious Diseases and director of Infection Control & Epidemiology at the University of Nebraska Medical Center, shared his expertise on evidence-based measures to prevent CLABSI/CRBSI. Peggy Prinz Luebbert, MS, CLS, CIC, CHSP, CSPDT, addressed interventions in preparing patients for surgery that help reduce the risk of SSI.

IP Survey: Human Factors and the Future of Infection Prevention

3M also highlighted the results from a survey of clinicians and infection preventionists (IPs), “Human Factors and the Future of Infection Prevention,” which uncovered the key challenges they face in their fight to reduce infections in their facilities.

The survey uncovered barriers that impact successful infection prevention, including a lack of adopting new technology and processes (51%), lack of senior leadership support (51%) and poor protocol compliance (50%). However, many IPs (45%) agree that their facility could prevent more infections with more high-quality data and tools. One-third of clinicians believe infections can be avoided entirely when providing care to patients.

We want to continue this conversation and find more ways to support clinicians in their fight against healthcare associated infections. Please join us July 11 for the first in a series of webinars to discuss the IP survey results.

Both the symposium and survey results emphasized the importance of preventing infections using a three-pronged approach: developing highly trained and committed people, incorporating industry standards and implementing evidence-based technology and we were excited to showcase some of our newest offerings that help clinicians in the fight to zero infections.

If you didn’t make it to the 3M booth at APIC 2018, here are some of the new product highlights:

3M™ Tegaderm™ Antimicrobial IV Advanced Securement Dressing

To better combat bloodstream infections, specifically peripheral line associated bloodstream infections (PLABSI), we introduced a new dressing to expand the 3M antimicrobial product offerings. The new dressing integrates 2% chlorhexidine gluconate (CHG) throughout the adhesive to suppress skin flora regrowth on prepped skin for up to 7 days, which can offer another line of defense against contamination. It also provides site visibility, catheter securement and is designed for consistent application. A non-bordered version of the dressing called Tegaderm Antimicrobial Transparent Dressing will also be available.

3M™ Skin and Nasal Antiseptic

Studies show that  approximately 30 percent of the population are colonized with Staphylococcus aureus (S. aureus), the leading cause of surgical site infections (SSIs). And, more than 80 percent of surgical site infections from S. aureus come from the patient’s own nasal flora. To combat this issue, 3M’s Skin and Nasal Antiseptic provides clinicians a simple, one-time application that reduces nasal bacteria, including S. aureus and MRSA, by 99.5 percent in just one hour and maintains this reduction for at least 12 hours. 3M’s nasal antiseptic is the only one supported by more than ten investigator-initiated clinical studies showing a reduction to the risk of SSIs.

3M™ Single-Patient Stethoscope

Leading healthcare organizations recommend using a single-patient stethoscope in isolation care settings, but the single-use stethoscopes on the market often fall short in terms of durability, sound quality and comfort. The new 3M stethoscope helps reduce the risk of cross-contamination  in isolation environments by providing clinicians a high-quality, disposable stethoscope that combines excellent sound quality and comfort to help eliminate the need to use personal stethoscopes.

3M™ Bair Hugger™ Temperature Monitoring System

Core body temperature is a vital indicator of health or illness of the acute care patient. For surgical patients, a small drop in core body temperature drop can result in unintended hypothermia (a temperature below 36.0°C), which can contribute to a number ofpreventable surgical complications. The 3M Bair Hugger™ Temperature Monitoring System is a non-invasive, consistent and easy-to-use system that accurately and continuously measures the patient’s core body temperature throughout the entire perioperative journey,  helpingclinicians proactively own the normothermic temperature zone and improve patient outcomes.

3M™ Attest™ Super Rapid Biological Indicator (BI) System for Steam and 3M™ Attest™ Auto-reader 490 and 490H units

Sterile processing professionals work to clean, disinfect, and sterilize all of the instruments that allow the perioperative staff to enter surgery prepared with the tools of their trade. 3M offers sterilization assurance solutions and expertise so the sterile processing department and your OR staff know surgical instruments are safe for patient use. Our new Attest™ Dual Auto-reader technology allows facilities to incubate both steam and Hydrogen peroxide BIs in the same auto-reader with fast 24-minute results – and is available via a free software upgrade to qualified hardware. Simplify, standardize and streamline Sterile Processing Department workflows with 3M innovation and expertise.

Sep 13, 2017

FDA: Keep using patient warming devices, including forced-air technology

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Bair Hugger Multi-Position Blanket Supine Shoulder

The 3M Bair Hugger forced-air warming system

The U.S. Food and Drug Administration recently issued a letter reminding healthcare providers that it continues to recommend patients be warmed during surgery when clinically warranted.

The FDA specifically mentioned that its recommendation includes the continued use of forced-air warming devices. The 3M™ Bair Hugger™ warming system is the world’s leading forced-air warming product.

The FDA said it recently became aware that some providers and patients are foregoing the use of forced-air warming because of concerns about a possible increased risk of surgical site infections. Those concerns have been driven by a 3M competitor and a group of plaintiffs’ attorneys, who are promoting a theory that forced-air warming devices such as the Bair Hugger system lead to an increased risk of surgical site infections.

The FDA, which regulates medical devices, said it has thoroughly reviewed available data and “has been unable to identify a consistently reported association between the use of forced air thermal regulating systems and surgical site infection.”

You can read the letter here.

You can read an update from the Minneapolis Star Tribune here.

Download the 3M™ Bair Hugger™ Research Compendium here.

Jun 23, 2017

8 Reasons the 3M™ Bair Hugger™ System is the Gold Standard in Patient Warming

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The 3M Bair Hugger System is the gold standard for patient warming. See the research in our updated Compendium.

The 3M Bair Hugger System is the gold standard for patient warming. See the research in our updated Compendium.

The 3M™ Bair Hugger™ forced-air warming system keeps patients warm throughout the perioperative process, which is integral to optimal clinical care and patient comfort. Below are eight great reasons you can trust the Bair Hugger system for your patient warming needs.

  1. Over 80% of US hospitals rely on the 3M Bair Hugger system to maintain normothermia.
  2. The 3M Bair Hugger system has safely and effectively warmed patients during surgery for nearly 30 years.
  3. More than 200 million patients have been warmed by Bair Hugger warming blankets or warming gowns.
  4. The number of patients warmed using the Bair Hugger system increases by nearly 50,000 each and every day.
  5. 8 of the top 10 orthopedic hospitals in the U.S. trust the 3M Bair Hugger system for their patient warming needs.¹
  6. The clinical effectiveness of forced-air warming has been documented in over 170 clinical studies and more than 60 randomized controlled clinical trials. Download the Bair Hugger research compendium to learn more.
  7. The 3M Bair Hugger system’s portfolio of 25 blanket designs (including seven underbody models) and three gown styles provides a warming option for nearly any surgical procedure.
  8. The 3M Bair Hugger Model 775 temperature management unit’s performance, precision and ease-of-use stands out from the competition.

Learn more about the 3M Bair Hugger system, or download the Bair Hugger Research Compendium.

1. U.S. News & World Report (online edition); 2015-16 Top Hospitals edition, Best Hospitals for Adult Orthopedics. http://health.usnews.com/best-hospitals/rankings/orthopedics. Published July 21, 2015.
Oct 20, 2016

Excitement builds ahead of ANESTHESIOLOGY® 2016

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Bair Hugger Patient Warming  Pediatric Donation

Excitement builds ahead of ANESTHESIOLOGY® 2016. Get a “sneak peek” at what we’ll be sharing. 

ANESTHESIOLOGY® 2016 is just days away, and we have some exciting announcements to share.

Since 1987, one of health care’s most iconic brands, the 3M™ Bair Hugger™ system, has provided innovative patient warming products with a singular purpose—the maintenance of perioperative normothermia in surgical patients.

Today 3M, a world leader in infection prevention, announced the launch of a revamped Bair Hugger brand. The 3M™ Bair Hugger™ Normothermia System incorporates a new visual identity with a more comprehensive product portfolio designed to better reflect its singular mission. The brand will be unveiled at the ANESTHESIOLOGY® 2016 conference in Chicago beginning Saturday, Oct. 22.

The Bair Hugger system, acquired by 3M in 2010 along with the Bair Paws™ patient adjustable warming system and the SpotOn™ temperature monitoring system, represents a legacy of industry first warming solutions and has safely, effectively warmed more than 200 million patients across the globe. The new Bair Hugger Normothermia System brand will incorporate all three product lines into one, cohesive normothermia solution to help clinicians measure and maintain body temperature throughout a patient’s surgical journey.

Our refreshed brand goes much deeper than just a new logo and brand name. It combines our customer-centric mindset with our deep industry expertise and a commitment to innovation, science and patient outcomes. The products in the 3M Bair Hugger Normothermia System are the same reliable solutions our customers use more than 50,000 times each day, now presented under a single brand name focused on maintaining normothermia, safeguarding outcomes and nurturing the patient experience.

Bair Hugger Multi-Position Blanket Supine Shoulder

New product launch 3M™ Bair Hugger™ Multi-position upper body warming blanket

The 3M™ Bair Hugger™ Multi-position upper body warming blanket, which will be unveiled at this weekend’s ANESTHESIOLOGY® 2016 conference in Chicago, is engineered to address these warming dilemmas with its ability to bend and conform to the patient’s body while providing uniform temperatures to the patient. The blanket is designed to maximize patient coverage with one easy-to-use warming solution. Its unique bendability enables clinicians to adapt the blanket to multiple surgical positions and procedures, to help maintain normothermia.

The multi-position upper body blanket highlights a new air channel design and lower profile, but still includes all the features that customer expect from a Bair Hugger upper body blanket, including integrated tie strips, adhesive strip, attached clear head drape and two resealable hose ports.

Charitable Contribution

And what better way to celebrate these two important launches than by giving back through a charitable contribution?

3M is pleased to announce that we’ll be making a $25,000 donation to the Ronald McDonald House Charities of the Upper Midwest. In addition, 3M is encouraging ANESTHESIOLOGY® 2016 attendees to visit the 3M exhibit (booth #2423) during the show to help us give even more.

Each visitor to the booth will be provided with a small vinyl cling and encouraged to apply it onto a large tracking thermometer. If the thermometer fills with clings by the end of the show, we’ll also be including 250 plush, purple bears along with our cash donation.

We look forward to seeing you at ANESTHESIOLOGY® 2016!

Oct 4, 2016

What is the Normal Core Temperature of the Human Body?

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Maintaining Normothermia: Core Body Temperature

The Answer May Surprise You.

Ask the question, and the answer is almost automatic: most people will say the normal core temperature of the human body is 37.0°C, or 98.6°F. If there’s any debate at all, some who regularly perform patient temperature monitoring and patient warming will say that this is the population mean temperature, while many textbooks on physiology, medicine and nursing authoritatively assert that this temperature represents the upper limit.

In fact, it is neither.

The Rise of the Little Red Arrows

Like other physiologic values, normal core body temperature varies across a normothermia range. When measured in large populations of normal individuals, 37.0°C (98.6°F) has no special clinical or statistical significance with respect to human thermometry.1, 2

A big part of why it persists is simply that it’s been around for a long time: 37°/98.6° as a mean core temperature was established in 1868 by Carl Reinhold August Wunderlich (1815-1877). Over time, it came to be symbolized by the little red arrows on those old (or relatively not-so-old) mercury-in-glass thermometers.

Despite accumulating evidence that the little red arrows are wrong, no one attempted a well-conducted confirmation of Wunderlich’s findings until the early 1990s. Today, though, we can more quickly discover how inaccurate we’ve been by simply revisiting two concepts from high-school chemistry: temperature scales and significant digits.

A Tale of Two Scales

Some temperature scales were developed pre-19th century, and were calibrated against somewhat arbitrary physical standards. The German physicist Daniel Fahrenheit (1686-1736), for example, developed his scale around 1717. “Zero” was the temperature of melting ice in a saline solution of unknown concentration3. As you might guess, Fahrenheit was also unaware of the metric system (which didn’t become popular until 1793, when the French discarded the Ancien Régime’s measures used during its year-long Reign of Terror)4. Instead, Fahrenheit set the normal temperature within the armpit or mouth of a healthy man at 96.3 He divided the distance between zero and 96 into 12 equal intervals, and then divided those into 8 units, or degrees.

Anders Celsius (1701-1744) developed his scale in 1742. He noted that the melting and boiling points of pure water were “persistent”: they always occurred at fixed points on the thermometer. He originally set the boiling point of his scale at 0 and the freezing point at 100 degrees; this direction was soon reversed by instrument makers.

After Fahrenheit’s death, his scale was recalibrated to make it easier to convert to Celsius. The degree was kept, but zero was redefined according to the freezing point and boiling point of pure water (exactly 32°F and 212°F).6 This revised Fahrenheit scale was used for most industrial work until the 1960s. Today, despite all but a tiny fraction of the world converting to the metric system 7, it is still widely used in the US even for some scientific and much clinical work.

The Truthful Point of Significant Digits

The degrees used in the Fahrenheit and Celsius scales are very different. A Celsius degree is almost twice as large as a Fahrenheit degree; a 5°C change is equivalent to a change of 9°F. This makes significant digits very important.

The significant figures of a number indicate how accurate a measurement is. For example, the temperature 37.3°C has three significant digits and is accurate to 0.1°C. On the other hand, 37°C, which has only two significant digits, is accurate only to 1°C. So, when a Celsius temperature with two significant digits is converted to a Fahrenheit temperature, the result cannot legitimately be more accurate than the original measurement. For example, a temperature of 33°C (two significant digits) is equivalent to 91°C (two significant digits). But a temperature of 33.0°C (three significant digits) is equivalent to 91.4°F (three significant digits). This expression has led to a type of numerical abuse commonly used to lend an air of scientific authority to a measurement or calculation.9 Worse, and much more important: the Fahrenheit measurement overstates the accuracy by one digit. As we are about to see, Wunderlich similarly mishandled significant digits, which partially explains the establishment of 98.6°F for the normal core temperature.10

A Flawed Methodology?

With the publication of his Das Verhalten der Eigenwärme in Krankheiten (On the Course of Temperature in Diseases) in 1868, Wunderlich firmly established 37.0°C (98.6°F) as the mean normal body temperature in adults.11 He arrived at this number after reportedly measuring nearly 1 million axillary and oral temperatures from about 25,000 patients, using a foot-long Celsius thermometer that took 15 minutes to equilibrate. In fact, Wunderlich observed and reported temperature ranges for diurnal variation and temperature differences for gender that are mostly consistent with modern values.11

But he obviously didn’t evaluate his entire dataset, and he also didn’t report just how he selected the data he used. He apparently averaged the Celsius temperatures from a subset of normal patients and computed a mean value of 37°C, a value that is accurate to only two significant digits.12, 13 He then mathematically converted the Celsius temperature to a Fahrenheit value of 98.6 – a value that overstates the precision by one extra digit.

Besides being evidently unaware of the principles of statistical analysis, Wunderlich was not overly concerned about what he considered to be minor inaccuracies in his instrumentation.11 In the second edition of his work on thermometry he wrote that “errors which do not exceed half a degree Centigrade (.9° Fahr.) are scarcely worth mention.”14 One of Wunderlich’s thermometers (discovered recently in the Mütter museum in Philadelphia) produced temperatures that were 1.9°C higher than an NIST-traceable reference thermometer.11

So What is the Real Mean Value – And What do We Do?

In the early 1910s, physiologists began measuring human core body temperature with great accuracy as part of their experiments with calorimetry. By the 1930s, they had produced sufficient evidence to suggest that the overall mean value for core temperature was considerably lower than Wunderlich’s value. The famous 20th-century Harvard physician and physiologist Eugene DuBois pointed out that in a temperature study conducted by Ivy in 1936, the value 98.6 lies well outside one standard deviation from the mean of 98.1°F.15 A well-conducted study by Mackowiak in 1992 confirmed that the core temperature in adults is normally distributed about a mean of 36.8°C (98.2°F). That study also indicated that 37.0°C doesn’t correspond to the overall mean, the mean over a 24-hour period, the median, or the mode of a large population.2, 12 In fact, 37°C lies outside the 99% confidence interval around the sample mean of 36.8°C.

Mackowiak and colleagues concluded that “thirty-seven degrees centigrade (98.6°F) should be abandoned as a concept relevant to clinical thermometry; 37.2°C (98.9°F) in the early morning and 37.7°C (99.9°F) overall should be regarded as the upper limit of the normal oral temperature range in healthy adults aged 40 years or younger, and several of Wunderlich’s other cherished dictums should be revised.”

That seems definitive, and likely establishes some revised metrics for health care professionals. As to the next steps, Professor DuBois was more succinct. In a lecture to the California Academy of Medicine in 1950, he suggested: “Would it not be wise to remove the little red arrows from our thermometers?

What do you think? Should accepted core temperature standards be revised? Comment below:

Resources:

1.         Sund-Levander M, Forsberg C, Wahren LK. Normal oral, rectal, tympanic and axillary body temperature in adult men and women: a systematic literature review. Scand. J. Caring Sci. Jun 2002;16(2):122-128.

2.         Mackowiak PA, Wasserman SS, Levine MM. A critical appraisal of 98.6 degrees F, the upper limit of the normal body temperature, and other legacies of Carl Reinhold August Wunderlich. JAMA. Sep 23-30 1992;268(12):1578-1580.

3.         Ruhf RJ. A lesson on the arbitrary nature of thermometer scales using the historical case of the creation of the Fahrenheit temperature scale. 2006; http://www.x98ruhf.net/temperature_lesson.htm. Accessed July 18, 2016.

4.         Alder K. The measure of all things: the seven-year odyssey and hidden error that transformed the world. New York: Free Press; 2002.

5.         Smith CS. A speculation on the origin of Fahrenheit’s temperature scale. Isis. 1965;56(1):66-69.

6.         Wikipedia contributors. Fahrenheit. Wikipedia, The Free Encyclopedia 2016; http://en.wikipedia.org/w/index.php?title=Fahrenheit&oldid=207221718. Accessed July 18, 2016.

7.         USMA. Metrification in other countries. 2016; http://lamar.colostate.edu/~hillger/internat.htm. Accessed 7/15/2016.

8.         Johnson A. Abolish the Fahrenheit thermometer. Washington: US GPO; 1916.

9.         Dewdney AK. 200% of nothing: an eye-opening tour through the twists and turns of math abuse and innumeracy. New York: Wiley; 1993.

10.       Blatteis CM. Body Temperature. In: Blatteis CM, ed. Physiology and pathophysiology of temperature regulation. Singapore ; River Edge, NJ: World Scientific; 1998:14-22.

11.       Mackowiak PA, Worden G. Carl Reinhold August Wunderlich and the evolution of clinical thermometry. Clin. Infect. Dis. Mar 1994;18(3):458-467.

12.       Shoemaker A. What’s normal? –Temperature, Gender, and Heart Rate. J Stats Edu. 1996;4(2):1-4.

13.       Cox P. Glossary of mathematical mistakes. 2001; http://www.mathmistakes.com Accessed 7/15/2016.

14.       Wunderlich CRA. On the Temperature in Diseases: A Manual of Medical Thermometry 2nd ed. London: The New Sydenham Society; 1871.

15.       DuBois EF. The many different temperatures of the human body and its parts. West J Surg Obstet Gynecol. Sep 1951;59(9):476-490.