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Editorial Comment: Manufacturer’s Response to Thermal Burn Associated with Intraoperative Convective Forced-Air Warming Blanket (Bair Paws™ Flex Gown System)

Rohr, Jodi M. MSN, RN, CNOR

doi: 10.1213/XAA.0000000000000085
Case Reports: Case Report

Department of Perioperative Technical Service, 3M Infection Prevention Division, 3M Center, Saint Paul, Minnesota,

Conflicts of Interest: 3M Infection Prevention Employee.

3M Infection Prevention Division commends Hansen et al.1 for sharing their root cause analysis of a minor patient thermal injury. The hospital identified practices that may have contributed to the injury and implemented corrective actions, both of which may help prevent future thermal injuries.

3M™ Bair Hugger™ blankets and 3M™ Bair Paws™ gowns are specifically designed to provide consistent, even heat across the entire blanket by using low resistance air-directing channels and manifolds unique to the Bair Hugger and Bair Paws systems. It is important to allow the air to travel freely by not compressing the air channels of the blanket. It is also important, in addition to checking the patient’s temperature every 10 to 20 minutes, to monitor the cutaneous response of patients who are incapable of reacting, communicating, and/or without a sense of feeling.

Furthermore, recommendation IX of AORN Recom mended Practices for Positioning the Patient in the Perioperative Practice Setting states:

After positioning the patient, the perioperative registered nurse should assess the patient’s body alignment, tissue perfusion, and skin integrity. Recommendation IX.a. After the desired patient position is attained the perioperative registered nurse should reassess the patient to include, but not be limited to, the following systems: respiratory, circulatory, neurological, and musculoskeletal/integumentary. Recommendation IX.b. The perioperative registered nurse should monitor the patient for external pressure from surgical team members leaning against the patient’s body. Retractors, equipment, or instruments resting on the patient and members of the perioperative team resting or leaning on the patient add to the risk of pressure injuries that cause nerve or tissue damage.2

Following 2 important practices, such as proper patient positioning and proper patient warming in accordance with the manufacturer’s instructions for use, is important to achieving the intended outcome of each process and crucial for patient safety. Educational videos for proper use and positioning of the Bair Paws flex gown are available at

Jodi M. Rohr, MSN, RN, CNOR

Department of Perioperative Technical Service

3M Infection Prevention Division

3M Center

Saint Paul, Minnesota

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1. Hansen EK, Apostolidou I, Layton H, Prielipp R. Thermal burn associated with intraoperative convective forced-air warming blanket: Bair Paws™ flex gown system. A & A Case Reports. 2014;3:81–3
2. AORN. . Recommended practices for positioning the patient in the perioperative practice setting. Perioperative Standards and Recommended Practices. 2014:425–44
© 2014 International Anesthesia Research Society