Without reference, identify principles about Blood Fluid Warmers with at least 70

percent accuracy.

Purpose◦ Used during various clinical procedures (mainly for

surgeries) to raise the temperature of refrigerated and room temperature blood or IV fluids as they are infused into the patient

Body temperature◦ Normothermia – normal core body temperature◦ When dealing with a medical patient (surgically or

clinically) normothermia is always important If a patient is over or under normal temperature the

body will strive for normothermia This extra effort will take away from the body’s ability to heal Hypothermia is the most frequent concern

Blood Fluid Warmers

◦ Negative effects of hypothermia Cardiac arrhythmias – myocardial infarctions are the

leading cause of unexpected death after otherwise routine surgery

Coagulopathy (prolonged or excessive bleeding) – caused by the body’s decreased release of coagulants

Decreased metabolism of numerous drugs causing slower recovery from anesthesia

Increased surgical recovery times and increased length of hospitalization

Increased risk of infection Raising the temperature of blood or IV fluids before

they are infused into a patient can significantly reduce the occurrence of hypothermia

Blood Fluid Warmers

In addition to hypothermia, infusion of fluid below normal body temperature can induce or aggravate physiologic conditions, such as cerebral perfusion

It is important to note that blood/fluid warmers only help to maintain normothermia They generally do not transfer enough heat to

significantly raise the body temperatureThis means they cannot effectively re-warm patients

who are already hypothermicTo significantly raise the body temperature of a

patient other means, such as hypo/hyperthermia or BairHugger units must be used

Blood Fluid Warmers

Blood Fluid Warmers

Use◦ Blood/fluid warmers are mainly used in surgery,

but may also be used in other areas such as: Emergency department Intensive care unit Some general patient care areas Blood bank

◦ Generally, blood/fluid warmers are setup and operated by either an anesthesiologist or a nurse anesthetist before and during a surgical procedure

Blood Fluid Warmers

◦ The decision to use a blood/fluid warmer and the correct type to use must be made by the clinician and includes the following variables: Patient size and weight Duration of the surgical procedure Rate of infusion or the total volume of

blood/fluid to be infused Temperature of the blood/fluid to be infused Availability of other patient-warming

techniques Clinician preference

Blood Fluid Warmers

Types◦ Blood/fluid warmers are typically categorized by

the method they use to warm blood/IV solutions◦ Most are in-line devices mounted on an IV pole.

They warm the solution bag or infusion device and the patient line and can be used in conjunction with the primary types of infusion devices including Gravity Pressure Pump

Blood Fluid Warmers

◦ The two primary methods of heating blood or IV fluids are water bath and dry heat Water bath

These units utilize a tank of warm water and special tubing

The tubing has an outer sheath in which warmed water from the tank is circulated

Blood or IV fluid passes through an inner tube, which runs between the sheath, and is warmed by the principle of conduction

Warmed blood or IV fluids are infused to the patient

Blood Fluid Warmers

Dry heat plate IV tubing is passed between two warming plates Blood/fluid warming takes place through conduction

between the plates and the fluids Dry heat cassette

Blood or IV fluids pass through a special chamber or cartridge

The cassette/cartridge fits in-between two warming plates

The blood/fluids are warmed through conduction

Blood Fluid Warmers

Advantages/disadvantages of each method◦ Water bath

Provides precise and controlled warming of blood/fluids for a wide range of flow rates

Require special disposable tubing sets Water from tank can be spilled

◦ Dry heat plate Generally only effective for heating blood/fluids

infused at low rates Do not provide rapid heating of blood/fluids Do not require special tubing sets Relatively simple devices

Blood Fluid Warmers

◦ Dry heat cassette Provide rapid and accurate warming of

blood/fluids for a wide range of flow rates Require special tubing/cassette sets

◦ In addition to the above units, there are some high-flow units that can both warm and deliver IV solutions/blood and are capable of warming and infusing fluids at higher rates than conventional blood/fluid warmers Blood/Fluid All units have primary and secondary (backup)

thermostatic or electronic controls to regulate temperature

Blood Fluid Warmers

All units have some type of circuitry that indicates the plate or water-bath temperature; however, the actual blood/solution temperature is not displayed

All units have an alarm circuit that terminate operation when an over-temperature condition occurs (usually slightly above 42°C – the point at which red blood cells are damaged)Visual/audible alarmHeater cutoff

Blood Fluid Warmers