How to warm IV fluids??

  1. Our Level I trauma center was told by JCAHO last year that we can no longer keep bags of IV fluids in "fridge style" warmers on the unit (like where blankets are kept but separate compartment).
    As a result, I think we're using warmed IV fluids much less often than we should & am looking for opinions from other EDs.
    Management says we should use the rapid infuser & our "Ranger" warmers (YES: we continue to use for traumas), but we end up using them in far fewer situations than we could - perhaps due to no more speed & simplicity of just pulling out room temp fluids.
    It was nice to use readily avail warm fluids for all kinds of pts - dehydrated little old ladies, babies, even a kidney stone pt who might feel chilled after a few liters.

    I'm tired of making my patients (mildly) hypothermic/increasing their oxygen demand & decreasing their comfort...

    What do you do in your ED?? ...thnks...
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    About 80sNurse, BSN

    Joined: Sep '08; Posts: 34; Likes: 8
    Corporate - Specialty Pharmacy; from US
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  3. by   dthfytr
    There are several fluid warmers on the market, I'm most familiar with the "Level 1" brand, both gravity and pressure infusion. They do the job well, but it seems that every machine that attaches to infusion tubing has it's idiosyncrasies.
  4. by   resumecpr
    Yep, a level one infuser will do the trick. I'm a little befuddled as to why your Level I Trauma Department doesn't have this type of equipment available.
  5. by   Larry77
    We went through a JCAHO survey not too long ago and they didn't say anything about our "fridge style" warmers. We date them for two weeks when we put them in. Did you guys date yours? I wonder what their justification was.

    We only have 2 Rangers in our dept for rapid infusion which would work for warming but they are big and to use them in some of the non-critical rooms would be a PITA.
  6. by   RN1980
    we have a older level 1 from our er when they got newer ones, they are do the trick but why should a pt have to pay for additional cost for the use of the machine and tubing when a simple warmed iv bag will do the trick. we always have 3 or 4 bags "hidden" in our blanket warmer.
  7. by   rubriam
    I would ask for clarification on why they do not want the fluids in the "blanket like warmer". Maybe that particular warmer is for blankets only and not for fluids.

    Ours have a separate compartments one for fluids and one for blankets and both have different temps. I agree with you I do not see why a patient should pay more for a level one unless there is a research study that has shown a contraindication in using those fridge warmers.
  8. by   mmutk
    What is the ideal or safe temperature for warmed IV fluids?

    The blanket warmer makes me nervous in that I can't technically guarantee a temperature of the fluids, I just assume it is near the temp setting on the warmer.
  9. by   Pixie.RN
    We also have the Level 1 brand of fluid warmer/rapid infuser. We cannot keep fluids in with our warm blankets ... as mmutk notes, we can't really control the temps with those fluids.
  10. by   Fribblet
    I warm mine in the microwave. When the bag starts to melt, I know it's done.

  11. by   Pixie.RN
    Quote from Fribblet
    I warm mine in the microwave. When the bag starts to melt, I know it's done.

  12. by   Larry77
    Our blanket warmers are set at 60 C, and our IV fluids at 40 C

    I'm not sure if this is ideal temp but like I said before we did just go through survey without any complaints JCAHO.
  13. by   star77
    Fluid is kept only in fluid warmer "Fridge style" space.

    Fluid is dated with an expiration.

    We go through a ton of it (level 1 trauma center, NorCal).
  14. by   80sNurse
    thanks, all!

    yes, we have & use level 1 & ranger; but we don't pull out the gear for as many non-trauma pts as I'd like.

    yes, we did date our fluids & keep in sep compartment from blankets, but JCAHO still nixed it.

    trying to see if JCAHO is inconsistent, AND trying to do increased use of (cost effective) warm fluids.

    keep those comments comin!