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| Member |
Is it true that when an IV is administered to a patient, especially in the field when it is cold, the patient can get hypothermia? | ||
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| You're going to feel a little pressure... |
If 1 liter of cold fluid is added to 6 or so liters of warm fluid, the average temperature of the 7 or so liters of fluid will go down. If you want that to happen (fever), that's a good thing. If not, and it goes down too much, then the pt will be hypothermic. Then, you have to fix that by adding warm blankets or warm fluids. Usually, the swings aren't large unless you're doing it on purpose (refrigerated or warmed fluids). I hope that helps answer your question. Bruce "The designer of the gun had clearly not been instructed to beat about the bush. 'Make it evil,' he'd been told. 'Make it totally clear that this gun has a right end and a wrong end. Make it totally clear to anyone standing at the wrong end that things are going badly for them. If that means sticking all sort of spikes and prongs and blackened bits all over it then so be it. This is not a gun for hanging over the fireplace or sticking in the umbrella stand, it is a gun for going out and making people miserable with." -Douglas Adams “It is just as difficult and dangerous to try to free a people that wants to remain servile as it is to try to enslave a people that wants to remain free." -Niccolo Machiavelli The trouble with fighting for human freedom is that one spends most of one's time defending scoundrels. For it is against scoundrels that oppressive laws are first aimed, and oppression must be stopped at the beginning if it is to be stopped at all. -Mencken | |||
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Member |
The short duration in the field is negligible under normal circumstances, since it's not often you get time to give more than one or two bags. However, we kept our IV fluids in a heated cabinet in the rig 'just in case'. That said, consider the results of not giving needed fluids... | |||
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Member |
Our Medic Units have heated fluids on board. "It's a Bill of Rights - Not a Bill of Needs" The World is a combustible Place | |||
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| Member |
Well said.... warmer is better but cold is better than nothing at all. One of your main priorities is having enough volume to maintain cardiac output. Better to be cold and alive than end up with a warm corpse. (edit) On second thought...maybe the OP is simply referring to the sense of being chilled if a pt. receives room temp fluids....this is not uncommon , but it doesn't mean that the person is hypothermic. They simply feel cold. It takes multiple liters of room temp fluids to actually make someone clinically hypothermic. I would guess , somewhere around 4-5 liters in 30-45 min. ( just a guess ). My personal record is 52 units of various blood products over 2.5 hours and an unknown number of liters of IV fluids. and yes I made him very hypothermic. | |||
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| In the yahd, not too fah from the cah  |
Same, although we usually reserve them for people who are legitimately cold. As others said if its just a liter or two the results are usually negligible because even if you're running it wide open it still takes a little while to infuse. | |||
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We Are...MARSHALL |
If enough fluid is given it can lead to a decrease in temperature but it would take a tremendous amount of fluid to lead to true hypothermia. In our trauma center we have rapid infusers that heat the fluid or blood being infused. We try to avoid cold as it is part of the trauma triad of death. Hope this answers your question. Build a man a fire and keep him warm for a night, set a man on fire and keep him warm the rest of his life. | |||
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| Member |
Thanks for the response. A few years ago I heard that having an IV fluid warming device in the field that could rapidly warm the fluid just before it is administered was needed and that conventional devices used to warm the liquid were not reliable (conduction or induction heating methods I believe, or nothing at all apparently). I had an idea in mind for a new way to do this but outside of an ER setting it doesn't sound like enough IV juice would be given anyway. | |||
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| We Are...MARSHALL |
In trauma we are trying to limit patients to 2 liters of IV fluid before we start transfusing blood products for resuscitation. Studies have shown larger volumes of IV fluids lead to worse outcomes than transfusing blood products early on. Build a man a fire and keep him warm for a night, set a man on fire and keep him warm the rest of his life. | |||
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| Member |
I don't know if this is State specific, but all of our ambulance IV is heated. There is nothing unreliable about it. The only catch to it is that if for some reason the heaters are offline for any period (maintenance for example) the fluid is replaced. but essentially not an issue. “So in war, the way is to avoid what is strong, and strike at what is weak.” | |||
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| Cut and plug |
We don’t warm our fluids at all. However I work for a large city in Texas so it’s never super cold here. Now that more ambulance services are carrying blood products which are stored cold. They are also carrying rapid warmers to heat it up before it’s given. | |||
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Corgis Rock |
We were on a field exercise at JBLM. In November. One of the company commanders went down and needed an IV. The only one handy was out in truck I brought it in and our doctor started it. He didn’t turn blue but swore he could feel the fluid working through his body. Never forgot to stay hydrated through. “ The work of destruction is quick, easy and exhilarating; the work of creation is slow, laborious and dull. | |||
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Oriental Redneck |
I'm guessing you're defining the term as cold enough to do harm to the body. You are not going to get hypothermia from IV fluid. Q | |||
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| Member |
I respectfully disagree..... | |||
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| Do No Harm, Do Know Harm |
Hypothermia in trauma victims is a big deal. Once the body temp drops below 95 degrees, clotting may not be possible. We had warmers when I worked EMS, and before we had warmers we'd keep a couple of bags on the dashboard, with the theory that they'd be warmer than if they were on a shelf in the back. Knowing what one is talking about is widely admired but not strictly required here. Although sometimes distracting, there is often a certain entertainment value to this easy standard. -JALLEN "All I need is a WAR ON DRUGS reference and I got myself a police thread BINGO." -jljones | |||
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