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Warming Fluids
Date: Mon, 11 Aug 1997 09:45:20 -0600 (CST)
From: jessica prewitt [jprewitt@ems.tdh.state.tx.us]

Greetings from Texas!

I'm wondering if anyone has any knowledge about or knows of research looking at methods of warming IV fluids in other than devices designed for that purpose. Specifically, is it safe/effective to use microwave ovens, blanket warmers, or warm water baths to warm IV fluids? Does the content of the fluid (D5 vs NS) affect the safety of these methods? Any assistance in this matter is much appreciated.

Thank you,

Jessica Prewitt RN, MSN
Regional Systems Coordinator
Texas Department of Health
Bureau of Emergency Management
1100 West 49th Street
Austin, Texas 78756-3199

Date: Tue, 12 Aug 1997 07:32:56 +0300 (IDT)
From: Gad Shaked [shakedg@bgumail.bgu.ac.il]

We use a microwave oven for warming crystalloids (N/S and Ringer's). No problem with that. Do not use it for blood and blood products!

G. Shaked
Dept. of Surg.
Soroka University Medical Center
Beer Sheva, Israel.

Date: Tue, 12 Aug 1997 12:01:57 -0600
From: NigthSurgeon [plango@doctormail.com]

All the methods you name are fit to warm up cristaloids exept for microwave ovens that should be avoided for warming up blood and its components .

I think that there are certain devices for sale in the US designed for the purpose and fit for ERs, sorry i can't recall the manufacturer .

Dr. P. Lango
Trauma Surgeon
Mazatlan General Hospital

Date: Tue, 12 Aug 1997 19:20:20 +0100
From: John Warwick [john.warwick@virgin.net]

If you leave them in the microwave for too long the bag explodes! Generally I found heating them for two mins was sufficient.

As a prehospital provider I now leave them on the dashboard and they stay at a steady 38-40 degrees for the whole shift.

(See Iatrogenic Hypothermia - A Valid Concern? 'Ambulance UK' 1995;10:4:12-13)

John Warwick. REMT-P
London Ambulance Service.
England.

Date: Tue, 12 Aug 1997 19:23:30 -0500
From: Matt Winters [mwinters@morgan.net]

The fluid manufacturer should be contacted to determine the proper methods of warming the fluids. Baxter tells us that our fluids may be stored in a fluid warmer (like the ones x-ray uses for their contrast media) for 15 days and then must be removed from the warmer if they are not used while in there. They may still be stored but cannot be re-heated as the plastic breaks down into nasty stuff. They also warn against the use of a microwave for the same reason. Your pharmcist can get the info you need from the manufacturer.

--
Matthew C. Winters, PA-C, EMT-P
Editor - SEMPA Web Page, located at..

Date: Sun, 17 Aug 1997 12:50:29 -0700
From: Charles E. Smith, MD [ces4@po.cwru.edu]

Jessica, You are skating on thin ice when trying to use devices not specifically designed for that purpose especially since there are some excellent products that have been well engineered for fluid and blood warning. It is not worth the trouble. Most systems don't work as well as commercial products such as Level 1 (blanket warmers, warm water baths- non counter current), and some are frankly dangerous with regards to uneven or unregulated heating, especially with blood and blood products (microwaves, towel warmers), handling of air ( jerry rigged systems), overheating, etc.

Chuck Smith
Charles E. Smith, MD
Department of Anesthesia
MetroHealth Medical Center
Cleveland, Ohio

Date: Tue, 19 Aug 1997 09:50:51 +0100
From: Dr. Ed Walker [Ed_trauma@limeland.demon.co.uk]

A simple way is to keep the bag of fluid under your jacket (if you are next to an entrapment, for instance), and run an extension coil round your leg (and any other warm bits).