What a difference a degree makes

Healthcare Purchasing News, Dec, 2005 by Jeannie Akridge

Another method of fluid warming involves the use of warming cabinets designed specifically for injection fluids, such as those offered by Enthermics Medical (Menomonee Falls, WI). The company offers solutions for warming blankets, injection fluids, and irrigation fluids all in separate cabinets and at different temperatures.

"You cannot warm injection fluids in irrigation cabinets and you cannot warm them in blanket warming cabinets. They must be warmed to proper temperature with a proper accuracy in a properly approved chamber," explained Mark Suszkowski, vice president, sales and marketing, Enthermics Medical.

While fluids warmed in a cabinet will not provide continuous injection at a constant temperature, Suszkowski contends that the initial injection of fluids into the patient is the most critical. Plus, the cabinets provide a readily available solution that doesn't need to be set up during surgery or authorized by a physician, and doesn't incur a cost for the patient. "If you have a lot of people and you have to make these decisions, our product would always be available."

Enthermics also makes warming cabinets for blankets. While not a clinical, active warming method, the blankets provide an extra layer of immediate comfort for patients thats shouldn't be discounted, said Suszkowski. "It's often the only positive thing that the patient remembers," he said. He describes cotton blankets as complementary to other methods of warming. "Nothing you do would ever replace the blankets. You're always going to have blankets and it's a lot better to have them warm. It's a psychological boost while the patient is conscious and it's part of the comfort and care offered by the hospital and the staff." The Enthermics cabinets are built to last for around 25 years, have insulated glass, are available with wheels and in counter top models, are stackable, and use no fans in the heating process for added durability.

Another common method for fluid warming is the use of dry heat technology, in which cartridges or warming plates are used.

Gaymar's Medi-Temp III blood and fluid warmer maintains temperatures between 38 degrees C and 43 degrees C at flow rates of up to 500 ml/min. A digital display of fluid temperature allows for easy monitoring, and includes a bubble trap with manual air vent.

Arizant's Ranger Blood/Fluid Warming System uses SmartHeat technology to provide heat only when it's needed. Highly conductive warming plates maximize heat transfer and the system responds to sudden changes in flow.

Temperature monitoring

Several guidelines point to the need to monitor the temperature of patients at key points throughout surgery. Ideally, temperature monitoring, when combined with the right temperature management techniques, will help ensure that patients never reach hypothermic conditions, and at a minimum, will alert surgical staff that aggressive warming measures need to be initiated.

"Temperature should be monitored in all cases where patients undergo general anesthesia. It's a simple step that's often overlooked," said Kimberly-Clark's Boothe. "And then it's pretty straight forward, if their temperature falls below 36 degrees C, there's overwhelming data that says they should be warmed back to 36. And they need to take whatever measures they have to, to treat everyone to that standard."