BURNS FROM WARMING DEVICES IN ANESTHESIA - A CLOSED CLAIMS ANALYSIS

Background: Prevention of hypothermia is an important aspect of anesth etic management. Methods used for its prevention may, however, cause c utaneous burns. We reviewed the American Society of Anesthesiologists (ASA) Closed Claims Project database to determine if there were recurr ent patterns of injury arising from intraoperative warming methods. Me thods: The ASA Closed Claims Project database is a collection of close d malpractice claims that have been reviewed in a standardized format. Ah claims for burns were reviewed. Results: Among the 3,000 total cla ims there were 54 burns, of which 28 resulted from materials or device s used to warm patients. Intravenous fluid bags or bottles warmed in a n oven and then applied to the patient's skin were responsible for 18 of the 28 (64%) burns associated with warming devices. These burns fro m intravenous fluid bags or bottles occurred in predominantly healthy (ASA physical status 1-2) young (age 38 +/- 17 yr, mean +/- standard d eviation) women undergoing routine gynecologic or peripheral orthopedi c surgery under general anesthesia. Of the eight burns from electrical ly powered warming equipment, five resulted from circulating-water mat tresses. Conclusions: Intravenous fluid bags or bottles warmed in an o perating room oven represent a hazard to anesthetized patients. Becaus e intravenous fluid bags or bottles are not an efficient method of pat ient warming, there seems to be little justification for their use.