As someone with a longstanding interest in the effective use of warming devices to avoid peri-operative hypothermia [1], I was interested in both articles in the correspondence section of your June issue (2-3). The article by S.M. Siddik-Sayyid et al was a useful reminder to remain vigilant to avoid thermal injury to our patients when using such equipment.
I was intrigued by their “before and after” illustrations. The photograph in Figure 3 was captioned “Lesion on left arm after a few hours” . However, having spent several minutes comparing this with Figure 2, the only difference between the two figures seems to be the extent of the skin discoloration on the upper arm. In all other respects, such as limb position, the position and course of the ECG leads, infusion line, oxygen tubing and the gown, all appear to be identical even down to the date and time recorded in the bottom right corner of each photograph.
I do not doubt their clinical observations and the generic importance of their message, but would be interested to know how to account for my observations.
DL Robinson
St. Peters’ Hospital
Chertsey
Surrey
KT16 OPZ
E –mail: david.robinson@asph.nhs.uk
References
1. Robinson D.L, Anis S. Warming patients in the lithotomy position. Anaesthesia 2004 (12):1249-50.
2. Thwaites A, Wildridge D, Jinks A. NICE and warm: but is it necessary. Anaesthesia 2010; 65: 649-650.
3. Siddik-Sayyid S.M, Saasouh W.A, Mallat C.E, Aouad M.T.Thermal burn following combined use of forced air and fluid warming devices. Anaesthesia 2010; 65: 654-655.