heated IV fluids

chico.medic said:
Another problem I have; is it really necessary to call someone, or his perception of something "stupid" because it differs from your own opinion?
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Yes, it is. The word stupid plays a very important role in the English language. It's a word that makes very clear and strong statements such as “what in the hell were you thinking” or “don’t waste our time with this BS.” Someone who uses the word stupid isn’t necessarily right; they just want to make it perfectly clear they’re not going to sit around and tolerate a certain level of dumbness.


I’m seeing an increased level of sensitivity among ems providers lately. I can’t explain why, all I know is it is annoying as crap. We have to walk on eggshells anymore because god forbid you hurt someone’s feelings. I’m not saying we should turn into drunken sailors but we shouldn’t be choir boys and girls either. This job requires a healthy dose of no none-sense reality every once in a while.
 
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Guardian said:
I’m seeing an increased level of sensitivity among ems providers lately. I can’t explain why, all I know is it is annoying as crap. We have to walk on eggshells anymore because god forbid you hurt someone’s feelings.
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:rolleyes:

Like I said before.....
chico.medic said:
BTW, it takes a lot for me to get my "feelings hurt". I agree, there is no place in medicine for ignorance, but let's not confuse a misunderstanding on an online forum w/ the ignorance of a provider. ;)
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We have IV fluid warmers in all of our units. I haven't needed to go to warm fluids much, or very often, however when I have needed to use them, it was very nice to have them.
 
Indeed, all of our vehicles have a fridge (which also has various drugs), and a heated cabinet (which usually also has blankets), most of the crews I've been on clinical placements with have had a bag or two of saline in each.

As an aside, N/S is the only fluid we carry, despite all (paid) Emergency Ambulances having two Paramedic or Intensive Care Paramedics onboard (or one of each).

-Nick
 
Wow. I know this thread is old, but I found it interesting.

In my 13 years of EMS in NYC, I have never once been on an ambulance with an IV warmer. Yes, we get some cold winters too!

The majority of the 911 units are run 24/7, and we idle our engines with the heat on in the winter.

For units that aren't run 24/7 (911 or private), we usually remove all the portable equipment (includes most of the ALS supplies) to an indoor locker.

Now I am curious to see if this is sufficient. I guess I'll have to wait until winter unless someone else already looked into this. Also, thanks for the idea of keeping an IV bag in my jacket.
 
Once again, sorry to revive an old thread. I am am a medic in Montana. It is not unusual to have winters that reach -50. I have seen frozen IV's and it is not pretty. We have commercial warmers in all the rigs and they work very well. We have started using a new product which I think is kick ***. It is made by a company called Dr.Down and it is an iv bag warmer that insulates the tubing as well. It comes with re-useable hot packs. It is not designed for everyday calls, but is useful for the lost hiker or avalanche victim where you have to hike in sub arctic temps.
 
Guardian said:
Anybody throw their cold IV bags on the windshield heater vents like I do on a cold morning?

Rid, the thought police are going to haul you away if you keep speaking your mind like that.
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I was starting to think I was the only one that did that.:)In the winter I usually keep 1 or 2 bags on the table with our radio and grab them on the way to the truck.
 
Ridryder911 said:
If the physician would had infused such IV fluids, the courts would have said it another word called gross negligence. Yes, there has been documented IV's from medics with ice in the bag. So yes, it happens, as well as physicians and nurses microwaving blood products to heat them! Know what happens when you microwave blood and fluids ?
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As well, even though I do not work in areas that have little frigid conditions we still have IV warmers for blood and fluids if it is cold outside; there called thermal angels developed by a paramedic for EMS, to prevent infusion of cold fluids. If all else fails, carry a bag of 500 on your coat with your body heat to maintain the warmth or on the defroster unit or make some type of device to maintain fluid warmth > 70 degrees.
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R/r 911
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Hello forum members,
I was Googling our company and Thermal Angel and ran across your discussion on fluid warming in the field. Our website has quite a bit of information on hypothermia if this would be helpful to anyone. The U.S. Military had done a great job in pushing the care far forward in the field, and fluid warming has always been a big concern.

http://www.thermalangel.com/html/hypothermiainfo.html

Let me know if I can be of service to anyone.

 
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So i guess i'll be the last the post to this "Hot" thread then...

From reading all the posts, it seems as if you perform active rewarming in the field?? No one one has mentioned anything about the core temperature of the patient. The guys always come to me and say: "we put up the ringers that was lyinig on the engine compartment (On the maybe hypothermic patient without taking a core temp)". I Chringe.

On this side active rewarming in the field is not provogated at all and rightly so. This is a process best reserved for the contolled environment, which we do not play in. Fully remebering that "...the patient is not dead until he is warm and dead" Think about it this way... Would you take a frosted glass out the the freezer and fill it with hot water??

Should you have a fluid warmer on the bus, it is great. But the guys who don't have try and improve by placing them strategically where it is warm. Does anyone actually monitor the temperature of these fluids and keep record?? The manufacturer of these fluids specifically states tht these fluids should be stored at a specific temperature. The problem is aggrivated by these fluids being exposed to continuous temperature changes I.E. hot cold hot cold.

More to follow.
 
Our service has a heated tray that holds four 1000ml bags of NS. We also heat two 250ml bags of D5W.
 
warm IV fluids

We have heating pads in all of our trucks to keep our fluids warm.
 
Speaking of physics.... you would be surprized how much heat you loose thru a standard 78" primary drip set. We did a little study on that, used 2 calibrated thermocouple thermometers ( Fluke.... for those wanting to know ), had one in the warmed fluid bag ( 110 degrees F ), the other at the end point of a catheter cannula ( 16ga ) wide open, and found out a significant enough drop in temp not to be worth the time or effort. Needless to say, we now warm the fluids with a coiled line between to hotpacks just before entry to the pt or insulate the pt.

But that was just us in our 'real world' findings. Others may have different results. Maybe that doc wasn't too far off.
 
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