Thank you to Mike for raising the questions and Rowley for answering them. I
have had similar issues about fluids on my mind for the past few months.
Regards
John Warwick
Flight Paramedic
HEMS London
----- Original Message -----
From: "Rowley Cottingham" <[log in to unmask]>
To: <[log in to unmask]>
Sent: 03 December 2000 21:48
Subject: Re: Warming Giving Sets
> > So three questions...
> > 1. Can giving sets be damaged by long term (one week) prewarming
> No idea, but I gravely doubt it. When I first started as a Consultant, the
pharmacy had decreed that each bag of fluid
> could only be put in a warmer once for a week. The result was that the
Unit was cluttered with hundreds of 'unwarmable'
> bags of fluid that had done their week. I got chapter and verse on this,
and pointed out that many tropical countries
> would have fluid stored at temperatures > 30 deg C for months without
apparent ill effect. So we now keep our fluids
> warmed for 6 months at a time, with no apparent degradation. I appreciate
that your question relates to the plastic of the
> tubing, which may be different from that of the bag. However, the same
tropical rules apply.
>
> > 2. Is there heat loss through a giving set
> Yes. The magnitude depends on the rate of flow, and the effect on the
patient is of course inversely proportional to this.
> So unless it freezes in the giving set I wouldn't worry.
> > 3. Is there evidence for 'non warmed' infusions affecting patient
> > outcome positively.
>
> Yes, and there is quite a lot of interest in this; hypothermia has of
course been used therapeutically for years in cardiac
> surgery, but the Houston experiments on cooling of brain injured patients
have I understand been unimpressive. It
> should be considered SERNIP C only at present (as should permissive
hypotension in trauma, but I'm fighting a losing
> battle on that one, I feel.)
>
> Best wishes,
>
>
> Rowley Cottingham
>
> [log in to unmask]
>
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