Considering an effective patient warming system that matches your expectations, and your budget can be a daunting task. Although preventing perioperative hypothermia is one of the most cost-effective ways to improve patient outcomes in the veterinary operating room, this dilemma is understandable. Not all warming systems are created equal. What works beautifully for small animal soft-tissue surgery may be a poor fit for exotics, or high-volume spay/neuter clinics. Below are the 10 crucial questions every buyer should ask before purchasing a patient warming system, with practical sub-questions as well as pros and cons to watch for.
1. What species and patient sizes will this system accommodate?
Why it matters: Veterinary patients range from tiny exotics to large dogs. A blanket or device that works for a 3 kg rabbit may be useless for a 40 kg dog, or vice versa.
What to ask the vendor
- For which species, size and weight ranges is this system designed
- Are there different unit, blanket or pad sizes available (small, medium, large, XL)?
- Are warming system accessories available?
What to watch for:
- Single size systems that only fit one patient range.
- Lack of proprietary accessories for very small or very large patients.
Tip: If you serve a wide variety of species or wide variety of animal sizes, prioritize systems with multiple units, blankets or pad sizes.
2. Does the system use forced air, resistive/conductive heating or circulating water, and what are the pros and cons?
Why it matters: The heating mechanism affects warming efficiency, budget, infection control considerations, and consumables.
Multiple considerations:
Forced air warming -
Forced air warming with a disposable warming blanket:
In this scenario a warm air blower is attached by a blower hose to a disposable warming blanket which is placed over the patient
Pros:
- familiar in many clinics
- many blanket sizes.
Cons:
- requires perpetual purchase of disposable blankets,
- concern of airflow from the disposable blanket over the sterile field,
- requires storage for consumables
- only warms a portion of the superior aspect of the body which is not part of the sterile field
- the disposable blanket is frequently used multiple times which can become the source of cross infection between patients
- the temperature surface of the blanket cannot be determined so it is not known if the patient is receiving inadequate or excessive warming
Forced air warming without a disposable warming blanket (a reusable system):
An example of forced air warming without the use of a disposable blanket or a reusable system is the HoverHeat Patient Warming System. With its use, any warm air blower that a clinic may have is connected to an underbody patient warming pad which levitates the patient and allows for low resistance warm air flow under the patient to warm the entire underside of the patient.
- no perpetual purchase of disposables
- no cross-patient contamination from multiple use disposables
- multiple sizes are available to accommodate any sized patient
- easily cleaned surface with a clinic’s current disinfectants
- warm air is blown away from the surgical field
- warms the largest surface area possible, the entire patient undersurface
- can be used for preop prep, surgery and postop recovery
- increases the warming capacity of any warm air blower by 50 to 75 percent due to increased surface area warming
- two HoverHeat units can be connected in series to warm the underbody and over body surfaces with one warm air blower
- a 2023 analysis found that facilities can save 66 percent on patient warming costs by switching to a reusable system in which there is no perpetual purchase of disposable blankets
- comfortable tissue-friendly underbody warming surface
- a recent HoverHeat innovation is the Temperature Probe Portal (Patent Pending) which allows for the use of a temperature probe to be placed so that the temperature of the HoverHeat warming surface, which is experienced by the patient, can be determined. A significant safety feature not available in any other forced air warming system.
- durable and long useful life
(Full disclosure: the author is the inventor of the HoverHeat and its accessories)
-
Resistive/conductive warming (e.g., resistive heating pads, heated mats)
Electrical warming pads consist of a under patient pad with internal resistive electrical wires or electrically conductive fabric which is connected to an electrical generator.- Pros:
- no disposable blankets are necessary
- reusable
- multiple sizes
- Cons:
- may heat more slowly
- potential for pressure-related hot spots and patient burns
- some systems have electrical pads that out date with time and can no longer be used
- fracture of internal wires in some systems
- Pros:
-
Circulating water mattresses
A circulating water mattress consists of a pad with a “radiator like” pattern of water channels which can be placed under or over the patient- Pros:
- good heat transfer and even warming
- can be used for over and under body patient warming
- Cons:
- bulky
- requires an electrical water pump to circulate water
- water channels frequently leak and cannot be repaired
- Pros:
Each active warming system brings its own unique attributes to the patient temperature management scenario. The clinician must weigh each system’s attributes as to its suitability for their unique facility and style of patient care.
3. What are the safety features and temperature controls?
Why it matters: Overheating, burns, inadequate warming, and pressure injuries are real risks. The system should have redundant safety controls and the ability to measure the temperature that the patient is experiencing
What to ask:
- What safety alarms and automatic shutoffs are included (overtemp, blanket disconnect, pad fault)?
- Can the system be set to a maximum temperature limit?
- Are there noncontact temperature monitors or integrated patient sensors?
- Is there an internal temperature sensor in the warm air blower or its hose?
- Can the surface temperature of the appliance (blanket or pad) delivering heat to the patient be measured?
- Does it meet relevant safety standards and electrical codes?
Red flags:
- No automatic overtemp protection.
Example of monitoring the temperature of the appliance providing warmth to the patient. The HoverHeat’s Temperature Probe Portal provides for the introduction of a temperature probe to provide continuous monitoring of the HoverHeat surface.
HoverHeat Temperature Probe Portal
4. How easy is it to clean, disinfect, and maintain?
Why it matters: Veterinary ORs face hair, body fluids, and tough cleaning regimens. A device that’s difficult to disinfect will accumulate contamination and downtime.
What to ask:
- Which parts are reusable and which are single-use?
- What are the manufacturer’s cleaning and disinfection instructions?
- Are there IPX or similar ratings for fluid resistance?
- What is the recommended maintenance schedule and estimated annual service cost?
Important specifics:
- Reusable pads should have wipeable surfaces compatible with common hospital disinfectants.
- Continued use of one disposable blanket on multiple patients can be the cause of cross infection between patients
- Avoid materials that trap hair or fluids.
5. What are the consumables, running costs, and lifecycle costs?
Why it matters: The sticker price is only part of the cost. Consumable disposable blankets, filters, replacement parts, and service often exceed the purchase price over time.
Ask for:
- Per-case cost of disposable blankets (if applicable).
- Typical lifespan of reusable components and replacement pricing.
- Warranty coverage, and costs for extended warranties and service contracts.
- Typical annual maintenance hours and downtime history.
- Life span of electrical warming pads
Tip: Calculate cost per case: (annualized capital cost + annual service + consumables) divided by cases per year. That gives your true ROI.
6. How compatible is the unit with your OR workflow and equipment?
Why it matters: A patient warmer that obstructs access, interferes with monitoring, or requires constant adjustments will be underused.
Questions to ask:
- How large is the unit and how much OR real estate does it require?
- Is the device portable for moving between rooms or for offsite clinics?
- How are cables and hoses routed to avoid contamination of sterile fields?
- Does it interfere with imaging, cautery, or other devices?
Practical considerations:
- Battery backups for use during transfers or power outages.
- Quick-attach blankets or pads to speed setup between cases.
7. Are Thermal Retention Blankets effective in preventing hypothermia?
Is an active warming system out of your budget or are you in need of an adjunct to your current active warming system? Consider the “poor man’s warming system”, thermal retention blankets. Effective examples are the ConRad Thermal Blankets. They have internal heat insulative and heat reflective layers to insulate the heat that the patient has or is receiving and reflect this heat back to the patient.
- can be used during anesthetic induction and preop prep to prevent heat loss due to anesthetic induced peripheral vasodilation
- can be used intraoperatively and postoperatively to prevent heat loss
- can be used as an adjunct to improve the effectiveness of forced air, electrical and water warming systems
- can be used in cages to prevent conduction of body heat to the cold steel floor
- easily disinfected with a clinic’s current disinfectants
- comes in multiple sizes
- blankets have a supple surface that is tissue friendly
- decrease laundry costs (average cost to launder one towel - $1.50)
(Full disclosure: the author is the inventor of the ConRad Thermal Blankets)
8. How user-friendly is the interface and what training/support is provided?
Why it matters: OR teams are busy; the easier the device is to set up and operate, the more consistently it will be used.
Ask about:
- Intuitive controls, preset temperature/weight profiles, and training materials.
- Availability of in-person training, video modules, quick-start guides, and troubleshooting checklists.
- Onsite or remote technical support hours and typical response times.
Tip: Request a demonstration video and illustrated instruction sheet.
9. What infection control implications should we consider?
Why it matters: Any device introduced into the OR can affect airflow over the surgical field, particle movements, sterility and cross patient infection. This is especially important in orthopedic or implant surgeries.
Ask:
- Does the system produce any airflow that could affect the sterile field?
- Does the forced air warming system blow air over or away from the surgical field?
- How are disposable blankets packaged and handled to minimize contamination?
- Can the forced warm air blower be used on an IV pole so that it is off the floor and not utilizing entrained air from the floor surface?
- Does the forced warm air blower have a HEPA filter
- Can the warming appliance in contact with the patient be disinfected with the clinic’s current disinfectants?
10. What are the warranty, service, and upgrade pathways?
Why it matters: Long-term vendor support determines device uptime and total cost of ownership. (Look at ROI – Section 5)
Ask:
- What does the base warranty cover and for how long?
- What are service response times and where are service centers located?
- Are software updates provided and are they free?
- Is there an option to upgrade components (e.g., newer blankets or sensors) later?
Helpful to know:
- Availability of spare parts and typical delivery times.
- Whether preventative maintenance visits are included or available at cost.
Conclusion
Patient warming should never be an afterthought. It is no longer acceptable to allow a patient to spiral into hypothermia. An effective patient warming system is an absolute clinical necessity. Your patients benefit and your facility’s bottom-line benefits. Great patient care doesn’t cost you money, it makes you money. With all this at stake, ask the right questions so that you get the right warming system for your facility and your patients.
