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Hello Recently I have been asked about a potential problem which was apparent on our ambulance. On the wall of our ambulances we have a pack which is designed to carry 5 x 500ml bags of fluid and maintain a constant warmth to the fluid. We have been keeping a couple of giving sets in the top of the infusion warmer - the idea is that by doing so there would be no heat loss from the fluid when running through the giving set (we also have a fabric cover which wraps around the giving set to reduce heat loss). Recently a technician set up an infusion ready for the paramedic and he noticed that the filter bulb was slightly damaged. We put this down to heat damage and took the giving sets off. Lengthy discussion has ensued about the potential damage to giving sets by placing them in the top of such warming units vs the benefits of maintaining heat in IV cannulation. One technician states that there is 'evidence' which leans toward non warmed fluid administration in trauma. I have not been able to clarify this 'evidence' and think it is probably something that someone has told him that he took as being true. So three questions... 1. Can giving sets be damaged by long term (one week) prewarming 2. Is there heat loss through a giving set 3. Is there evidence for 'non warmed' infusions affecting patient outcome positively Mike Bjarkoy Paramedic Sussex