Why operating rooms are cold (not what you thought)

Why are operating rooms so cold? It's not to prevent infection. And it is annoying to anesthesiologists. In this video, I explain why ORs are cold, and what measures are taken to protect patients against problems associated with low temperatures.

0:00 Start
0:47 Complications of cold
2:21 Keeping patients warm
4:01 The actual answer

Cited sources:
Morgan & Mikhail's Clinical Anesthesiology, 7e
Hakim et al 2018 "The Effect of Operating Room Temperature on the Performance of Clinical and Cognitive Tasks"
Katz 2017, "Control of the Environment in the Operating Room"

Music:

The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.

#Anesthesiology #Residency #MedicalSchool

[DamonJohnCollins]

Thank you. I manage construction in hospitals. It's worth pointing out that in OR construction, we strive to have more supply duct surface area in the ceiling (over the patients) so we can get those 20 air changes done with slower air speed. And we balance the supply to be the same speed across the entire face so that we create a laminar flow (of HEPA filtered air) across the patient (and sterile field) to also lower SSI.
Another factor is making that air speed slow enough to reduce noise in the OR, but, fast enough so that movement around the Sterile field doesn't stir up dirty air around the patient while keeping the OR positively pressured (relative to the corridor).
Thanks again, your content really helps me to understand why it's important to construct OR's the way we do.

[loverlei]

Everytime I go in for surgery I have to tell everyone involved especially the anesthesiologist:
"I have an upper spinal injury and can't regulate my body temperaturen so I'll need that really cool heated blanket thing, and you will need to watch me."
The anesthesiologist always appreciates the heads up that I'm a lizard person and not to ever trust my body temp.

[jmacd]

After a literal 48 surgeries, I’m finally getting an explanation. I was always flippant with my Doctors that they were taking me to the morgue instead of the operating room. Thanks for the important information.

[TheDisturbedAngel]

I remember when I was going through my military nursing school roughly 18 years ago, I spent some time in a burn unit and that OR was kept quite warm (100F if I remember?) due to how extensive the burns we delt with were (often 80% and more TBSA) and I vaguely remember being told it was due to how unequipped the patients were to regulate their own body temp.

[valuedhumanoid]

I commented that I didn't think the surgery was going to happen in a meat locker. The nurse went into the blanket heater and returned with 3 heated blankets. The doctor was wearing all the crap you were saying, the nurse even said he would overheat if it wasn't that cold. No joke, that surgeon had two helpers getting all the stuff on and when he came to visit me afterwards in recovery, he looked like he was playing basketball. He just looked hot and sweaty. He said he goes thru scrubs all day long

[sissyroxx]

I quit my surgical nursing position because I kept getting very ill from the constant cold. I constantly shivered and couldn't control my body movements. It also caused me to feel a frequent need to empty my bladder. I never questioned the cold temperature because my nursing instructors taught us it was to lower the chance of infection for patients. Wow!

[XRROW_]

This really opens my eyes to how hard anesthesiologists work and what they have to take into consideration.

[IHeartQuilting]

Both surgeries I've had since 2014, they put heated blankets on me once moved to the surgery room. They automatically do this for patients with diabetes, but also patients over the age of 60 (I was in 50s at the time). If you tend to be cold when others are comfortable or hot, be sure to mention this when you are in the pre-surgery prep room.

[GeoffreyFeldmanMA]

You might find it interesting to visit a semi-conductor production facility. The standards for removing particulates and exchanging air are many times more rigorous than OR's. In fact, in some parts, there isn't anyone in the facility at all. It's just robots. I worked for a company that had a smoke-enders program in which the technicians participated. The production crashed. It turned out that earlier they had tweaked the process to get the yields they wanted. Now that technicians were not smoking, not exhaling or sweating out the biproducts of the habit, the tweak was now wrong. They untweaked and all was well. This demonstrates just how sensitive the chemistry is. All that was a "Sub micron" facility but now, it's 5 nanometers and - no humans allowed.

[swedneck]

before watching: my immediate thought is to limit bacterial growth

[peachmelba]

I firmly believed it was to freeze out bacteria, viruses and other pathogens. I did have one warm operation, when I had my gastric Bypass at the Ohio State University in Columbus Ohio. My anestheologist actually asked if I was comfortable before I went off to LaLaLand- I knew if He was That Considerate- I was in Pefect Hands!

[publicenemynumerouno]

Okay, I watched this from beginning to end. I hope you keep an affiliation with a hospital that trains doctors and nurses. You have an enormous aptitude for keeping the material interesting and engaging. I've had three 'procedures' so far and while it was just an idle curiosity why the room was so cold now I at least understand some of the reasons why. Thank you very much!

[FoxDragon]

When I was a few weeks away from turning 13, I had an accident that resulted in a skull fracture requiring a fairly intensive surgery. I think it was the nurse who said something to either myself or my parents about asking for a warm blanket for my surgery, or maybe it was someone else on the team. I don't remember a whole lot of those 2 weeks that I was in the hospital, but I do remember the discussion of a hot blanket, and when it was actually time for my surgery, the sensation of a heavy, warm something being draped over me as someone told me to start counting back from 100 (and I only remember getting as far as 98) and then I was talking to someone in the recovery room.

[gendoll]

We kept our recovery room pretty cool after I gave birth and the doc actually told us we had to turn it up cause it could’ve been contributing to our newborn daughter not gaining weight quick enough. Like her body was working to keep her warm and in turn burning calories. She never shivered or anything and the nurse turned the temp down, not us lol. It was just interesting!

[marvinmuller]

For a pulmonary endarterectomy the patient`s body temperature needs to be at around 18°C. Therefore, the warming blanket is actually used to cool the patient down, the heart-lung-machine cools the patient`s blood but also the room temperature is lowered even more. In my opinion it gets really cold in the OR during this specific procedure. Thats why i like to wear scrubs with long sleeves for a PEA.

[laurawood]

Thank you for your videos, I’ll be having my 10th surgery tomorrow thanks to my autoimmune disease. No matter how many times I’ve been through it, anesthesia still makes me nervous every time. But watching your videos really humanizes it and makes it less nerve wracking. Thank you! 😊

[valeriecarpenter]

Matt's video series on general anethesia was a huge help for me. Had surgery shortly after watching these and I was significantly less anxious & stressd out because I knew what the anesthesiologist would be doing, in what order & why they were doing each part of the procedure. I can''t thak you enough for making this series. Great job.
👍

[eden]

It’s freaking freezing in the OR. This is really interesting

[amandacarr]

Yes, you’re right it keeps the surgeon and surgical tech cool, but it has a more important role. It helps to keep the humidity down as well. Humidity/condensation can present a problem with maintaining a sterile field. Also, you don’t want a surgeon sweating his eyebrow over an open patient.

[lizziebjl]

I also believed it was to reduce bacteria. I wonder where these ideas start?
I’ve had 14 operations in my life and I must say the most important person in the operating room is you! When I have my pre-op chat with the anesthesiologist, I tell them so ! ❤