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STANDARD:
* All registered nurses are approved to conduct cooling measures.
* Observe temperature minimum of Q1L.
* Temperature measured via a rectal probe or IDC temperature sensor.
* Create heat loss through convection and evaporation.
* Minimise heat production by limiting anxiety and/or movement.
* Institute measures singularly from least to most stimulating until effect produced.
* Observe for vasoconstriction, increasing temperature, deteriorating LOC, vital signs.
OUTCOME:
* Maintain core temperature <39.5%C and >36%C in general ICU patients.
* Maintain core temperature <38%C and >36%C in all patients with cerebral disorders.
* Maintain core temp just below upper limit avid rapid rise and fall.
PROCEDURES:
* Institute following singularly and in order 1-4:
(1) Expose patients trunk thighs and arms to room air.
(2) Tepid sponge vasodilated body surface areas.
Obtain doctors prescription for use of:-
(3) * a fan
(4) * ice to arterial points (axilla, carotids, femoral)
(5) * sedatives/paralytics. NB: these may be used in conjunction with all of the above.
R : 11.1
* Turn patient on side to side regularly if possible.
* Notify Physician of increasing temperature or ineffectual intervention.
* Cease measures if vasocontriction and/or shivering occurs.
NURSES ROLE:
* Observe and record temperature.
* Observe and record patients progress and effect of nursing/medical intervention.
* Notify Physician of complications.
Reviewed October 1995
R : 11.2
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