Thursday, August 20, 2015

The Operating Room Is Freezing Cold Because Of...Sexism?

We make all sorts of excuses for why the operating room temperature is always so freezing cold. Now we may have a more scientific explanation for this. An article in the New York Times discusses why office buildings are frequently set so cold that many female workers feel the need to wear sweaters and use heating fans at work while their male colleagues still complain about sweating through their suit jackets.

This environment was first studied back in the 1960's when scientists developed a "thermal comfort model" for what temperature makes people to feel comfortable. It takes into consideration factors such as metabolic rate, air temperature, radiant temperature, and clothing insulation to determine the ideal environmental temperature. The equation looks something like this:

PMV = [0.303e-0.036M + 0.028]{(– W) – 3.96E-8ƒcl[(tcl + 273)4 – (tr + 273)4] – ƒclhc(tcl – ta) – 3.05[5.73 – 0.007(M – W) – pa] – 0.42[(M – W) – 58.15] – 0.0173M(5.87 – pa) – 0.0014M(34 – ta)}

However, as it turns out, this model was based on an ideal 40 year old male who weighs 70 kg. Presumable this applies to the size of surgeons at that time too, who back then were overwhelmingly male.

This may have been true back in the 60's but most modern men are bigger, frequently much bigger, than this hypothetical male. A 70 kg American male is now a rare minority. Along with an increase in size of the body, the metabolism rate also goes up. Therefore operating room temperatures continue to get ratcheted down as our ever larger male surgeons keep complaining of hot OR's while covered from head to toe in water proof protective gowns.

Meanwhile the rest of us in the OR's who are relatively skimpily outfitted in our scrubs and may not have the same metabolic rate as the surgeons are left chilled to the bone, rubbing our hands to restore circulation to the fingertips while absconding with every blanket available in the blanket warmer. The small female circulating nurses wrap so many blankets around themselves that they look like they're wearing flannel burkas. And the poor patient laying on the operating room table suffers the most of all, wearing nothing except a cold layer of wet betadine that has been applied to the skin.

Now some people are discussing the possibility of changing the formula to account for the fact that women have metabolism rates that are 20-30% lower than men. There should also be adjustments for the larger diversity of people that work in the hospitals now compared to fifty years ago. Patients should be at the top of the list for reasons to adjust the operating room thermostat. Their health and successful outcomes depend on it. Surgeons should just buy stronger antiperspirants and deodorants for the sake of their patients.

1 comment:

1. Definitely some interesting thoughts. I definitely agree with your thought at the end: the patients should be the first concern. And it's important to adjust things every so often to reflect how professions are changing.