Kurz et al studied the effect of hypothermia on postoperative surgical site infections in patients undergoing colorectal surgery. Two scales were used to monitor thermal comfort and shivering postoperatively. The authors are from the University of California San Francisco, University of Vienna, and University of Graz (Austria) and were members of the Study of Wound Infection and Temperature Group.
Original scales used postoperatively:
(1) visual analogue scale (VAS) for thermal comfort
(2) 4 point Likert scale for shivering
Thermal Comfort was a 100 mm line, with:
(1) 0 mm indicates intense cold
(2) 50 mm indicates thermal comfort (not hot or cold)
(3) 100 mm indicates intense warm
|
Shivering
|
Grade
|
|
none
|
0
|
|
mild or intermittent
|
1
|
|
moderate
|
2
|
|
intense, continuous
|
3
|
Both scales seem to have drawbacks for use. The shivering includes measures for severity and frequency. Therefore, I propose modifications for both measures.
Thermal comfort is graded as feeling cold, feeling comfortable, or feeling warm.
If cold, a VAS is scored from 0 to 100 mm, with 100 mm intense cold.
If warm, a VAS is scored from 0 to 100 mm, with 100 mm intense warmth.
A person who is in thermal comfort would have a VAS for cold of 0 and a VAS for warmth of 0.
|
Shivering Factor
|
Finding
|
Points
|
|
severity of shivering
|
none
|
0
|
|
|
mild
|
1
|
|
|
moderate
|
2
|
|
|
severe
|
3
|
|
frequency of shivering
|
rare
|
1
|
|
|
intermittent
|
2
|
|
|
continuous
|
3
|
total points for shivering =
= (points for frequency) * (points for intensity)
Interpretation:
• minimum shivering score: 0
• maximum shivering score: 9
