Covenant Health Compassiara1e rote led by Catholic m laes Blood/Fluid Warmer Neonatal Nursery Policy & Procedures Manual Policy Group: Intravenous Approved by: Gail Cameron Director, Maternal, Neonatal &Child Health Programs Dr. Ensenat Medical Director, Neonatology Date Effective August, 2012 Next Review August, 2015 Dr. Peliowski Medical Director, Neonatology Purpose Equipment The blood/fluid warmer is used to provide safe and effective warming of blood, blood products, and liquids. Ranger blood/fluid warming system Alarm indicator light Alphanu me ri c display Power switch Bubble trap holder Neonate disposable IV. blood/fluid delivery set - Model 24450 A A) Fluid Warming Cassette B) Inlet Clamp C) Inlet Line D) Patient Line E) Fluid Aspiration Port B F) Air Aspiration Port G) Bubble Trap H) Pati'ent Clamp D
Date Approved Policy Group Page 2 of6 Procedure Setup of Warming Unit and Priming of Warming Cassette ACTION RATIONALE 1. Perform hand hygiene before handling of Standard precautions. equipment. 2. Slide the fluid warming cassette into the Priming of the warming cassette will slot in the warming unit before priming. not allow for proper insertion into the The cassette can only fit into the device warming unit. one way. 3. Connect the inlet line to the blood/solution set. 4. Invert the bubble trap and prime the inlet Infusing fluid with air bubbles present line and bubble trap until full. Turn the may result in an air embolism. bubble trap right side up and prime the patient line. Priming volume of the set is 20 ml. Ensure that all air is removed from the line.
Date Approved Policy Group Page 3 of 6 5. Place the bubble trap into the holder on the warming unit. 6. Close the patient line clamp and turn the warming unit ON. In a few seconds the alphanumeric display will illuminate. It should take less than 2 minutes to warm up to the 41 C set point temperature. Removal of Warming Cassette ACTION 1. Close the inlet clamp proximal to the fluid warming cassette and open the patient line clamp distal to the cassette. RATIONALE 2. Allow the fluid to flow into the patient (this may take 2-3 seconds) then close a distal clamp 3. Remove the fluid warming cassette from the warming unit and discard accordingly. Please refer to the product website for videos that provide additional information on warming fluids and the fluid warmer itself: http://www.arizant.com/us/rangersystems/videos
Date Approved Policy Group Page 4 of 6 Troubleshooting CONDITION CAUSE SOLUTION Nothing illuminates on the warming unit panel Unit is not turned on, Turn unit on. Make sure plugged in, or power cord the power cord is plugged is not plugged into an into the power entry appropriate outlet module of the warming unit Make sure the warming unit is plugged into a properly grounded outlet. Unit failure Notify unit manager or designate. Temporary over-temperature condition because: An extreme change in flow Open flow to reduce rates occurred temperature. Alarms will stop when the display reads 41 e. Alarm indicator illuminates and alarm sounds, alpha-numeric Unit was turned on and Alarms will stop when the display alternately flashed a reached set point display reads 41 e temperature of 43 e or higher temperature before and the word "HI" warming cassette was inserted Fluids were prewarmed to Turn off unit. Discontinue above 42 e before being infusion of fluids. Do not run through the warming warm fluids before infusing unit them through the warming unit. Alarm sounds, alpha-numeric display and alarm indicator light go dark Primary controller failure. Unit will no longer operate. Power to heating plates will shut off if temperature rises to 44 e Turn unit off and unplug it. Discontinue use of unit. Alarm will continue to sound if you do not unplug unit. Notify unit manager or designate. Independent backup Unplug unit. Notify unit Alarm sounds but unit has been safety system has been manager or designate. turned off activated
Date Approved Policy Group Page 5 of 6 CONDITION CAUSE SOLUTION Unit alarms soon after plugging it in (unit does not have to be turned on for this to occur) Heater temperature rises to 44 C and unit shuts down soon after plugging it in (unit does not have to be turned on for this to occur) Test screw on bottom of unit is loose or missing. Make sure test screw is completely tightened. If it is missing, turn unit off and unplug it. Notify unit manager or designate. Cannot remove warming cassette from unit Warming cassette is too full, fluids are still being infused, or clamp is open proximal to the warming cassette Warming unit is below patient level, creating excessive back pressure Make sure fluid is drained from warming cassette before sliding out the cassette, that flu ids are no longer infusing, and that the clamp is closed proximal to the warming cassette Raise unit above patient level Alarm indicator light illuminates and alarm sounds, alphanumeric display alternately flashes a temperature of 33 C or below and the word "LO" Under temperature condition caused by very high flow using a very cold fluid, or defective heater/relay Alarm should stop when temperature rises above 33 C. If alarm continues, unplug unit and discontinue use. Notify unit manager or designate. Alpha-numeric display reads "Er 4" or "Open" Open wire on temperature sensor Do not use unit. Notify unit manager or designate. Alpha-numeric display reads "Er 5" or "Open" Electrical interference Remove the unit. Refer to biomedical technician or notify unit manager or designate. Related Documents RELATED POLICIES AND PROCEDURES Exchange Transfusion Revisions Blood/Fluid Warmer, October 2005
~Health Date Approved Policy Group Page 6 of6 Signing GAIL CAMERON DIRECTOR MATERNAL, NEONATAL & CHILD HEALTH PROGRAMS COVENANT HEALTH GREY NUNS & MISERCORDIA HOSPITALS DATE DR. SANTIAGO EN~_ MEDICAL DIRECTOR NEONATAL PROGRAM COVENANT HEALTH GREY NUNS HOSPITAL MEDICAL DIRECTOR NEONATAL PROGRAM COVENANT HEALTH MISERCORDIA HOSPITAL