Do We Make Trauma Patients Worse............

[paramedicmike]

We don't carry a thermometer. So I cannot measure fluid temp.

I found this article from Emergency Medicine Australasia printed in 2001. It's only the abstract as I'm having trouble getting access to the full article itself.

Keywords:

• hypothermia;
  
• intravenous fluids;
  
• microwave;
  
• resuscitation.
  

Abstract

Objective:

To determine if intravenous fluid heated in modern microwave ovens is warmed to a consistently safe temperature, as has been advocated in a number of texts and journals.

Methods:

Five, 1L bags of normal saline in Viaflex (Baxter Healthcare, Old Toongabie, NSW, Australia) containers were heated for 2 min on high setting in 16 different microwave ovens. The output power ranged from 650 to 1000 W. All microwave ovens were equipped with electronic timers and turntables. Initial and final temperatures were recorded with a TestoTerm 1100 electronic thermometer (Dade Behring, Lane Cove, NSW, Australia), accessing the centre of the fluid via the injection port. The average and standard deviation for each measurement was determined for each microwave oven.

Results:

In nine out of the 16 microwaves (56%) tested, the fluid had reached an average final temperature greater than 42°C and thus was greater than the recommended maximum temperature for the heating of intravenous fluids. All microwave ovens with an output power of greater than 900 W overheated the fluids. However 13/16 microwaves (81%) had a temperature range less than 3°C, thus if correctly calibrated could be appropriate for heating intravenous fluid for resuscitation.

Conclusions:

The increased output power of modern microwave ovens can lead to overheating of resuscitation fluids, if the simple algorithm currently recommended is followed, leading to potentially serious complications. Microwave heating of intravenous fluid could be a safe, simple, cheap and effective means of heating intravenous fluids for resuscitation, but care needs to be taken to calibrate individual machines to ensure a safe temperature is reached.

I also found another article from the journal Anesthesiology talking about burns resulting from warmed IV fluid. There's no abstract available and I haven't been able to get access to the full text yet. Once I do I'll post some highlights.

[island emt]

Mike is correct. Manufacturers recommend that after 2 weeks in a heated state the fluids be replaced. '

Even with our small call volume service , we don''t waste too many bags / year. We date them when they go in the warmer and chuck them to the training box at 2 weeks. We keep 2 liters in the warmer at all times.

[flamingemt2011]

I can not believe you guys are kissing butt over a 30 minute dissertation on light molecules. The manufacturer suggests that the fluid be maintained around 77 degrees, and states that short periods of temperatures above 104 do not damage the fluid. There, I gave you 28 more minutes to do something constructive:

http://www.rxlist.com/normal_saline-drug/indications-dosage.htm

[chbare]

What is a light molecule?

[paramedicmike]

Ok. The second article I was looking for didn't tell me anything like what I was expecting to read. It didn't deal with warmed IV fluid administration. Rather, it discussed using warmed IV fluids as a hot pack to help surgical patients in the prevention of hypothermia. Specifically, prolonged application of warmed fluids under pressure can cause up to full thickness burns.

What is a light molecule?

Zing!

Unfortunately, I believe our friend, to whom this was directed, won't get it.

[chbare]

I'm certainly not here to intentionally zing anybody or get a one up, but a potentially teachable moment may have occurred. Maybe not for the OP, but others. If I can perhaps clear up some confusion and if the OP will listen, all the better.

[DFIB]

I can not believe you guys are kissing butt over a 30 minute dissertation on light molecules.

It is a guy thing.

Simply appreciation for a friend sharing his knowledge and time when he probably had better things to do.

Edited December 23, 2011 by DFIB

[paramedicmike]

I'm certainly not here to intentionally zing anybody or get a one up, but a potentially teachable moment may have occurred. Maybe not for the OP, but others. If I can perhaps clear up some confusion and if the OP will listen, all the better.

If, after watching your video, our friend has not learned anything then any potentially teachable moments have passed. You were quite clear and presented your information in an easy to understand manner. If he failed to learn anything that failure is on him.

Your intent might not have been to offer any zingers. But you have to admit, even knowing the intent behind your question, that was a pretty sharp response.

[DwayneEMTP]

He only had one reason for posting...so that he could use the term 'kiss ass' as I'm sure he believes it sounds really gay.

He's a poster that can't make even the most simple of points so it comes as no shock that he wouldn't understand Chris' post.

Had the presentation sucked I would have been grateful for it simply because expending the effort shows so much of what I hope that the City can be someday...

I'm going back to calling bullshit on Flaming's medic status. He's most likely a clever basic that can't get past his medic envy but doesn't have the balls to pay his dues and actually step up to the plate. He's hoping that he can somehow win it instead in a lawsuit.

And for the record shithead, no one was questioning whether or not the fluid was damaged by heat but by the seemingly common knowledge that microwave ovens in particular create an issue.

Should you ever actually make it medic school, please choose one that demands at least a 5th grade level of reading comprehension. But, you don't have the stones for it....there, I just saved you two years to do something productive with.

Dwayne

[chbare]

If, after watching your video, our friend has not learned anything then any potentially teachable moments have passed. You were quite clear and presented your information in an easy to understand manner. If he failed to learn anything that failure is on him.

Your intent might not have been to offer any zingers. But you have to admit, even knowing the intent behind your question, that was a pretty sharp response.

True that.

I absolutely appreciate all the great response I've received. I just want to be careful because I don't want to come of as being pretentious.