Staying Warm in Surgery

Started by futuredo32
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futuredo32

futuredo32

Senior Member
20+ Year Member
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Any tips for staying warm in the OR? I started my surgery rotation Monday and although it's not the specialty for me, I am enjoying many aspects of surgery. The one problem I have had is staying warm. One case on Monday lasted about 3 hours or so and by the end of the surgery and waking the patient up, I was shivering and my hands were so cold, they were kinda blue. Has anyone else experienced this and found a way to overcome it?
 
I wear 2 undershirts underneath my scrubs. There are ORs that don't allow any undershirts. Don't know what to tell you there.

I guess you could always wear thermal underwear as that's typically tougher to spot 😉
 
futuredo32 said:
Any tips for staying warm in the OR? I started my surgery rotation Monday and although it's not the specialty for me, I am enjoying many aspects of surgery. The one problem I have had is staying warm. One case on Monday lasted about 3 hours or so and by the end of the surgery and waking the patient up, I was shivering and my hands were so cold, they were kinda blue. Has anyone else experienced this and found a way to overcome it?
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My experience has always been the opposite. If you are scrubbed in you will be under a heavy gown and wearing gloves, a hat a mask. And standing under fairly hot lights. And probably leaning against the bear hugger heating device anesthesia has wrapped the patient in. We are talking big time sweat fest. I've come out of long surgeries drenched. If you are truly cold after all this, then wear another layer. Even if your OR forbids undershirts, there are ones you can get that will not be seen under scrubs (unless the scrubs are see through, in which case there's a whole 'nuther reason to feel hot in the OR :laugh:).
 
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I'd advise you that with my method, you will sweat like a pig if you're gowned up. I'm typically freezing when standing on the side and watching.

Typically sweating like a pig when under the lights.

It's no wonder I'm opting for a field away from the OR.

If you're just standing on the sides watching, you can always ask for a gown and wear that on top as well. (like the anesthesiologists)
 
If you're scrubbed in, you'll have no problem staying warm. You'll be wearing a long gown and gloves and you'll be under hot lights. If you're not scrubbing in, though, sometimes they have a kind of cloth gown that you can wear over your scrubs, only its not sterile. If you know what type of gown I'm talking about, ask the circulating nurse if you can borrow one of those, if she's nice. If she's mean, then stay the hell away from her!
 
Law2Doc said:
Or raid that cabinet where they keep the warm towels/blankets. Every OR wing has one.
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After the patient goes to the PACU, I run for the warm blanket whenever possible. I have a new found appreciation for blankets.
leagueelbow said:
I'd advise you that with my method, you will sweat like a pig if you're gowned up. I'm typically freezing when standing on the side and watching.

Typically sweating like a pig when under the lights.

It's no wonder I'm opting for a field away from the OR.

If you're just standing on the sides watching, you can always ask for a gown and wear that on top as well. (like the anesthesiologists)
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Law2Doc said:
My experience has always been the opposite. If you are scrubbed in you will be under a heavy gown and wearing gloves, a hat a mask. And standing under fairly hot lights. And probably leaning against the bear hugger heating device anesthesia has wrapped the patient in. We are talking big time sweat fest. I've come out of long surgeries drenched. If you are truly cold after all this, then wear another layer. Even if your OR forbids undershirts, there are ones you can get that will not be seen under scrubs (unless the scrubs are see through, in which case there's a whole 'nuther reason to feel hot in the OR :laugh:).
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Thanks to both of you.🙂 I'm going to try to find a hard to detect t-shirt or two. I am freezing gowned up and under the lights, I don't think sweating will be a problem, but I think I'd prefer that to freezing.
 
I know a classmate who would wear UnderArmour athletic apparel underneath his scrubs.

But that might have been for aesthetic reasons 🙂
 
futuredo32 said:
After the patient goes to the PACU, I run for the warm blanket whenever possible. I have a new found appreciation for blankets.

Thanks to both of you.🙂 I'm going to try to find a hard to detect t-shirt or two. I am freezing gowned up and under the lights, I don't think sweating will be a problem, but I think I'd prefer that to freezing.
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I had the same problem. Shivering and blue hands if I wasn't scrubbed in. When I was scrubbed in, I was still a little cold, but it wasn't as horrible. I always hated taking everything off at the end of the case, though, because the shock of the cold OR would really get to me. I would wear long underwear pants and a tank top under my scrubs every day. I would also run to the lounge between cases when I could for hot water from the coffee dispenser and sip on it (the water normally used for tea, but I just wouldn't put tea bags in it). Any time we had to walk from building to building, I would try to take the outside route (it was summer), so I could warm up a little in the sweltering houston heat. Also, when I wasn't scrubbed in, once the patient was asleep, I would dash for the blanket warmer and wrap myself up during the case. I just made sure to keep the blanket tight around me and would rarely get dirty looks from scrub techs assuming I'm about to start twirling around, flailing the blacket about and knock into all their sterile stuff.
 
Wear two scrub tops, then you'll be warm and no-one will know. I know a lot of people who do this, and you can never tell.
 
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Just keep in mind that if you're in on a trauma case, the OR is definitely NOT cold. In order to prevent hypothermia they tend to crank up the temp which sucks for people who dont know this. During 3rd year i was scrubbed in on such a surgery where the AI in on the case was drenched in sweat. It was a long 3hr surgery. I don't know how the AI managed to get through it.
 
EternalMD said:
Just keep in mind that if you're in on a trauma case, the OR is definitely NOT cold. In order to prevent hypothermia they tend to crank up the temp which sucks for people who dont know this. During 3rd year i was scrubbed in on such a surgery where the AI in on the case was drenched in sweat. It was a long 3hr surgery. I don't know how the AI managed to get through it.
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3 hour = long? I'm not sure where you did surgery!
 
leagueelbow said:
There are ORs that don't allow any undershirts.
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I've never heard of one that disallows ANY undershirts - that seems pretty ridiculous. As if it'd be better to have my chest hair hanging through the V-neck? I have heard of the "no undershirt that extends past the scrub sleeve" rule though, which seems reasonable. Of course, most of the fat scrub techs contaminate their upper forearms anyway with their poncho-like scrub tops.

If someone calls you out on wearing an undershirt, you can tell them to take their made-up infection-prevention noise somewhere else.
 
CANES2006 said:
Scrub in.😎
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I am scrubbing in.

I've worn a t-shirt and it helps a little, but I'm still cold.
I'm going to look into ordering some of the "cuddleduds" and getting express shipping this weekend. I'll try drinking some hot water too after I find the coffee machine.🙂
Thanks so much to everyone for the advice.🙂 I'm glad to know I'm not the only one in the world who is freezing in the OR. The temperature doesn't seem to bother any of the nurses /attendings/ residents that I work with.
 
futuredo32 said:
I am scrubbing in.

I've worn a t-shirt and it helps a little, but I'm still cold.
I'm going to look into ordering some of the "cuddleduds" and getting express shipping this weekend. I'll try drinking some hot water too after I find the coffee machine.🙂
Thanks so much to everyone for the advice.🙂 I'm glad to know I'm not the only one in the world who is freezing in the OR. The temperature doesn't seem to bother any of the nurses /attendings/ residents that I work with.
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They're probably cold. They just don't want to admit it. That way they can jump on the student and harass him/her if s/he voices the tiniest complaint about how cold the OR is.
 
The other day I saw an anesthesiologist use the hose from an extra Bair Hugger machine and stick it down her polar fleece vest...I thought it was both genius and quite funny! Though, I know that's not an option for you while you're scrubbed 😉.

I am normally the type of person that gets hot really easily, but I sometimes get cold and will grab an extra gown from Center Core.

You may also think about buying some of those Therma Care heat wraps for back pain...they last at least 4 hours and might help keep you a little bit warmer.
 
futuredo32 said:
The temperature doesn't seem to bother any of the nurses /attendings/ residents that I work with.
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I like a colder OR. Yes, cold enough where, if I didn't scrub in, I'd probably be very close to shivering.

The ONLY time that I've come close to passing out was in a breast case where the room was warmer than usual. When I was scrubbed in, I was very, very warm. So warm, in fact, that I almost vasovagaled...TWICE.
Fortunately, each time, I unsteadily made my way over to a stool as soon as I started getting REAL bad tunnel vision...so I didn't end up taking the sterile field with me.

Both times, I had to scrub out, go to the (freezing cold) bathroom, and splash icy cold water on my neck, arms, and down my shirt front.

Ever since then, I've tried to work with attendings that are known for having Arctic-like ORs. Better to be cold than to wipe out the sterile field with your face.
 
SoCuteMD said:
3 hour = long? I'm not sure where you did surgery!
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Well I considered it long considering I started call at 6am, non-stop traumas all day, last ate dinner at 7pm with nothing to drink and then ended up in the OR at 4am for the 3hr case. So being up close to 22hrs, I think anyone would consider 3hrs a long case when sleep deprived, dehydrated, in a hot as hell OR

I just left out those details because i didnt think anyone would focus on the time in the OR but rather the temperature as the OP was asking about
 
fakin' the funk said:
I've never heard of one that disallows ANY undershirts - that seems pretty ridiculous. As if it'd be better to have my chest hair hanging through the V-neck? I have heard of the "no undershirt that extends past the scrub sleeve" rule though, which seems reasonable. Of course, most of the fat scrub techs contaminate their upper forearms anyway with their poncho-like scrub tops.

If someone calls you out on wearing an undershirt, you can tell them to take their made-up infection-prevention noise somewhere else.
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Nope. It's true at my home hospital. Can't bring your own scrubs. And can't wear undershirts.

It's easy to rebel against that rule on an online forum.

Harder to do it in person against the scrub nurse nazis. (I think every hospital as one. This one giant fat female who's so miserable that she has to take her frustrations out on medical students.....)
 
smq123 said:
I like a colder OR. Yes, cold enough where, if I didn't scrub in, I'd probably be very close to shivering.
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Ditto. Those REALLY warm rooms? Like the ones for Trauma or Burns? Absolutely brutal.
 
futuredo32 said:
I am scrubbing in.

I've worn a t-shirt and it helps a little, but I'm still cold.
I'm going to look into ordering some of the "cuddleduds" and getting express shipping this weekend. I'll try drinking some hot water too after I find the coffee machine.🙂
Thanks so much to everyone for the advice.🙂 I'm glad to know I'm not the only one in the world who is freezing in the OR. The temperature doesn't seem to bother any of the nurses /attendings/ residents that I work with.
Click to expand...

I am one of those folks who is perpetually cold. My serum iron is very low and most of the time I can be anemic on any given day. That being said, I opted for light-weight Damart [brand] undershirts (the double-force stuff will keep you warm at 55 below zero) and tights under my scrubs. I still wear the tights but now that I am the attending, I can stand closer to the Bair Hugger and keep warm. Also, as the case goes on, the lights do heat the room to a certain extent. (Just don't let the sleeve of your shirt go below the sleeve of your scrub top.). The other thing that you can do is double gown. Just put a larger outer gown over a smaller under gown.

When I was a resident on call, I used to sleep under the SICU "french fry" lights to keep warm. The nurses laughed at me but I was toasty warm as I basked in their red glow. I would sit in my office under those lights. They were the best.

I would also caution you not to wear gloves that are too snug. If your gloves are tight, they tend to cut down on blood flow and your hands stay colder. Try a half size up on the gloves.
 
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njbmd said:
When I was a resident on call, I used to sleep under the SICU "french fry" lights to keep warm. The nurses laughed at me but I was toasty warm as I basked in their red glow. I would sit in my office under those lights. They were the best.
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Didn't you know you're famous for wearing your thick sweatshirts while on call? 🙂
 
futuredo32 said:
Any tips for staying warm in the OR? I started my surgery rotation Monday and although it's not the specialty for me, I am enjoying many aspects of surgery. The one problem I have had is staying warm. One case on Monday lasted about 3 hours or so and by the end of the surgery and waking the patient up, I was shivering and my hands were so cold, they were kinda blue. Has anyone else experienced this and found a way to overcome it?
Click to expand...

I was always hot in the OR with the several layers of clothing. But keep in mind, I keep my apartment at 67 degrees at night.
 
Just wanted to say that wearing Cuddleduds really helped A LOT, in case anyone else finds themselves freezing in the OR.
 
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