A Simple and Easy Method to Prevent Intravenous Fluid Heat Loss in Hypothermia

저체온 환자 치료에서 정맥주입 수액의 열손실을 막는 간단한 방법에 관한 고찰

  • Lee, Sun Hwa (Department of Emergency Medicine, College of Medicine, Ewha Womans University) ;
  • Choi, Yoon Hee (Department of Emergency Medicine, College of Medicine, Ewha Womans University) ;
  • Lee, Dong Hoon (Department of Emergency Medicine, College of Medicine, Chung-ang University)
  • 이선화 (이화여자대학교 의학전문대학원 응급의학교실) ;
  • 최윤희 (이화여자대학교 의학전문대학원 응급의학교실) ;
  • 이동훈 (중앙대학교 의과대학 응급의학교실)
  • Received : 2013.09.24
  • Accepted : 2013.10.24
  • Published : 2013.12.31

Abstract

Purpose: For the treat hypothermia patients, active warming might be needed. In most emergency departments, IV warm saline infusion is used for treatments. However, during IV warm saline infusion, heat loss from the warm saline may occur and aggravate hypothermia. Thus, in this study, we conducted an experiment on conserving heat loss from warm saline by using a simple method. Methods: Four insulation methods were used for this study. 1) wrapping the set tube for the administration of the IV fluid with a cotton bandage, 2) wrapping the set tube for the administration of the IV fluid with a cotton bandage with aluminum foil, 3) wrapping the warm saline bag and tube with a cotton bandage, and 4) wrapping the warm saline bag and tube with a cotton bandage with aluminum foil. Intravenous fluid was preheated to a temperature between $38-40^{\circ}C$. The temperatures of the saline bag temperature and the distal end of the IV administration set were measured every ten minutes for an hour. The infusion rate was 1000 cc/hr, and to obtain an accurate infusion rate, we used an infusion pump. Results: The mean initial temperature of the saline bag was $39.11^{\circ}C$. An hour later, the fluid temperature at the distal end of the fluid temperature ranged from $39.11^{\circ}C$ to $34.3^{\circ}C$. Without any insulation, the initial temperature of the pre-heated warm saline, $39^{\circ}$ had decreased to $34.8^{\circ}C$ after having been run through the 170-cm-long IV administration tube, and after 1-hour, the temperature was $29.63^{\circ}C$. As we expected, heat loss was prevented most by wrapping both the saline bag and the IV administration set with a cotton bandage and aluminum foil. Conclusion: Wrapping both the saline bag and the IV administration set with a cotton bandage and aluminum foil can prevent heat loss during IV infusion in Emergency departments.

Keywords

References

  1. Tsuei B, Kearney PA. Hypothermia in the trauma patient. Injury 2004; 35: 7-15. https://doi.org/10.1016/S0020-1383(03)00309-7
  2. Moola S, Lockwood C. Effectiveness of strategies for the management and/or prevention of hypothermia within the adult perioperative environment. Int J Evid Based Healthc 2011; 4: 337-45.
  3. Jurkovich GJ, Greiser WB, Luterman A, currerei PW. Hypothermia in trauma victims. An omnious predictor of survival. J Trauma 1987; 27: 1019-24. https://doi.org/10.1097/00005373-198709000-00011
  4. Walters FJM, Nott MR. The hazard of anesthesia in the injured patient. Br J Anaesth 1977; 49: 707-20. https://doi.org/10.1093/bja/49.7.707
  5. Giesbrecht GG. Prehospital treatment of hypothermia. Wilderness Environ Med 2011; 12: 24-31.
  6. Richardt P, Christopher S, BTech. Three insulation methods to minimize intravenous fluid administration set heat loss. Prehospital emergency care 2013; 7: 68-72.
  7. Faries G, Johnston C, Pruitt KM, Plouff RT. Temperature relationship to distance and flow rate of warmed IV fluids. Ann Emerg Med 1991; 20: 1198-200. https://doi.org/10.1016/S0196-0644(05)81470-2
  8. American college of Surgeons. Advanced Trauma Life support. Chicago: American college of Surgeons. 1997.
  9. Fildes J, Sheaff C, Barrett J. Very hot intravenous fluid in the treatment of hypothermia. J Trauma 1993; 35: 683-7. https://doi.org/10.1097/00005373-199311000-00005
  10. Michael T. Robert O, Wright, Bruce M, Becker, James G, Linakis, Gregory D. Factors and methodology in achieving ideal delivery temperatures for intravenous and lavage fluid in hypothermia. AM J Emerg Med 1997; 15: 350-3. https://doi.org/10.1016/S0735-6757(97)90122-4
  11. Brown DA, Boeck DE, Morgan M. An evaluation of the Level 1 blood warmer series. Anesthesia 1990; 45: 960-3. https://doi.org/10.1111/j.1365-2044.1990.tb14631.x
  12. Bowen DR: Efficiency of the Thermal JacketTM on the delivered temperature of pre-warmed crystalloid intravenous fluid. J Am Assoc N anesth 1992; 60: 369-71.
  13. Leaman PL, Martyak GG. Microwave warming of resuscitation fluids. Ann Emerg Med 1985; 14: 83-6.