Warming Fluids and Blankets

Most Canadian Hospitals would have blanket/fluid warmers and the basic benefits of its use are obvious to us all.

By providing warm blankets we are providing more than just comfort; it is a great safety measure for preventing hypothermia, surgical site infection, improving medicinal effectiveness and much more. Click the links below for educational publications.

THE REALITY
The unfortunate reality is that the warming cabinets are put into service and often with little or no training or understanding of clinical studies. Here are some of the common misconceptions that I run into when making site visits at hospitals.

-Mixing blankets and fluids
Blankets are typically warmed to 150-200 F (65-93C) for most effectiveness. Click Here to view a study conducted on blanket temperatures and effectiveness. Fluids on the other hand cannot sustain these temperatures and will shorten the effective life of the IV solution. Injection fluids are warmed at 104F (40C) while irrigation fluids may be warmed to a maximum of 150F (66C). There will be ill effect on the IV Fluids since the blankets create an additional convection heat that will over warm the fluids and reduce its effectiveness and/or lifespan. If you are warming both fluids and blankets, you will need a dual chamber cabinet.

-Stuffing the blanket compartment
To ensure that your blankets are evenly warmed, you should leave air space around all edges of the compartment. By over stuffing your blanket compartment you will decrease the warming value of every blanket in the cabinet.

-IV fluid life span
You should refer to the instructions from the supplier of your IV solutions for the longevity of warmed fluid. Fluids cannot remain in the warming cabinet indefinitely without some effect to the solution. Usually it will be good for up to 14 days and then the fluid should be removed from the cabinet and discarded. We recommend that you train all staff to "Take from the front" and "supply to the back" however if you don't use a lot of fluids regularly, it is suggested to not use the warming cabinet for storage . It is important to implement a system so that fluids do not remain in the warming cabinet for longer than what is specified by the IV supplier.

-Anything On Bottom Shelf Will Catch Fire
I can't count the amount of times I have seen the sign taped to the old warming cabinet stating that "Blankets will catch fire on bottom shelf". This is a disturbing thought, especially if fluids are being kept in this cabinet. Current warming devices are regulated to +/- 2 F so that you know what you are offering the patient and that your fluids are not spoiled due to overheating. Additionally, it takes temperature exceeding 250F to start a blanket smoldering which is way above recommendations. If that is the temperature of the bottom shelf; what temperature are the remaining shelves?

BENEFITS TO WARMING BLANKETS WHEN USED CORRECTLY

  • Maintains Normothermia
  • Reduces shivering, therefore the use of oxygen
  • Reduces vasoconstrictions
  • Reduces potential for surgical site infection (SSI)
  • Provides Comfort
  • Improves recovery time

BENEFITS TO WARMING FLUIDS WHEN USED CORRECTLY

  • Maintains Normothermia
  • Fluids are absorbed faster
  • Improves recovery times