PD Manual - Keeping Bags Warm

[joyfulmother]

Do any of you have tips for keeping your bags warm?  I am using a small cooler that holds about 4 - 5 bags (2500 ml).  I have the heating pad that Baxter sent me with my supplies.  So far all I have tried is the pad laying on the bottom and the bags horizontally on top of it.  The two on the bottom get warm enough but not the rest.  Standing them up vertically doesn't do much either.  I wish I could figure out how to warm the whole cooler so if I had to use a 2.5% I would know it was warm without having to arrange the bags ahead of time.

Just thought you guys might have some ideas?

[rookiegirl]

I only do 2 exchanges per day.  I use the heating pad from Baxter too.  The bag (purple cap Icodextrin) I use to exchange in the morning, I wrap the heating pad around the solution and lay it down on top of my exchange table.  I turn the heating pad on Medium heat around 11pm and when I wake up to exchange around 6am, my bag is pretty warm.

My 2nd bag (normally green cap Dextrose), I do the same thing and turn it own around 6PM when I get home from work.  By 10:30-11pm, I'm ready to do my second exchange and my bag is warm.

This is how I've been doing it for over a year.  I tried the cooler but it really didn't make a huge different.  After my PD training they started me on the cycler which I didn't like.  The only thing the cycler was good for is heating my bag.  That is what I miss about the cycler.

[peleroja]

I used to heat my bags in the microwave, until one night the electricity failed just before my 10 pm exchange.  I bravely went ahead and did the exchange and didn't have any problems (the nurse had said I might cramp).  Being the lazy person I am, I never attempted to heat my bags again.  Just a thought.

[djgaryb11]

When i was using the manual bags, I probably had a larger cooler then you, but i would lay 2-3 bags on the bottom of the cooler...laying flat...then on top of those bags i would lay the heating pad....and then on top of the heating pad i would lay another 2-3 bags...that way the heating pad was in contact with all the bags and all would stay warm.

[Restorer]

Like rookiegirl, I warm my bags one at a time with a heating pad. I do 4 exchanges a day. When I do an exchange, I put a new bag on the heating pad on the lowest setting, and it's warm by the time I do my next exchange. This way, I always have a bag ready, and it's no extra time to warm up a new bag - I just cycle the bags across the heating pad as I use them.

That doesn't provide as much flexibility in choosing a dextrose concentration, though. I pretty much have to predict what I'll need 5 hours (or a night) ahead of time, but I don't find it a problem. My fluid weight doesn't seem to fluctuate very fast.

[mikey07840]

I know this is going to sound terrible, but when I do manual bags, I usually don't warm them at all. Room temperature works well for me. The cycler won't let me use a non warmed bag. If I try to use a room temperature bag, it makes me wait until it is heated.

[DenverLaura]

I was having a lot of trouble warming bags, so I got a second warming pad from my clinic.  I put one in the bottom of my cooler, lay the bags on top, and then place the second on top of that.  Just make sure you use the low setting or you'll end up with a bag that's too hot.  The cooler alone makes a big difference if you can't get a second warming pad (I live in Denver, so I need a little extra warmth).

~DenverLaura

[george40]

I used to heat my bags in the microwave, until one night the electricity failed just before my 10 pm exchange.  I bravely went ahead and did the exchange and didn't have any problems (the nurse had said I might cramp).  Being the lazy person I am, I never attempted to heat my bags again.  Just a thought.

Last week in order to stay on schedule I did an exchange with a room temp bag. It wasn't too bad. It has been a week and I haven't warmed a bag since. lol

[Hanify]

I did one in the car (driving home from an appt) and it was room temp and fine.  I guess it depends how cold it is where you are.  Do you have a microwave?  You can always do that if the warmed bag isn't the one you need.

[KICKSTART]

Im sure we are told NEVER use a microwave !!!! How do you know that its not going to be too hot! It might feel ok to the touch but .... Over here we have a regime that we have to stick to , so as you use one bag , you then put a new bag on the warmer and its ready by the time you do your next exchange. How come you dont stick to a regime ? I would say if you are really stuck , either put the fluid in without warming it , worse it will do is give you a bit of stomach ache or get a hot water bottle rest your fluid bag on that then wrap it in a towel !

[Hanify]

I was taught to use a microwave by my renal people.  We do it for five minutes on half strength.  Interesting how different everyone is.  They don't advise us to use the microwave all the time, but think occasionally it's ok.

[Savemeimdtba]

I have my bags in a basket with the heating pad on the bottom - I put one 1.5 and one 2.5 so both are warm incase I need to use something different.  It worked for me... I'm on the cycler now so it doesn't matter anymore.

I was told never to use the microwave either...  I have tried using the bags at room temperature and it gives me a stomach ache so I'd rather not. 

[Hanify]

I think another major difference over here is that we are allowed to swim in the sea!  Are you guys?  Apparently our renal people believe the salt water kills the bacteria.  I love swimming and I really miss it, so I love getting the chance to have a bit of a swim. 

[circleNthedrain]

When I was on PD I had a gas oven that had a pilot that was on all of the time.  I would keep several bags in the oven and with the piolot light they would stay just about body temperature.  It was great in the wintertime.  Just be sure to remove the bags before turning the oven on!

[Savemeimdtba]

I think another major difference over here is that we are allowed to swim in the sea!  Are you guys?  Apparently our renal people believe the salt water kills the bacteria.  I love swimming and I really miss it, so I love getting the chance to have a bit of a swim.

Yup, we are allowed to swim the ocean (or atleast at my clinic we are) and personal pools where we know the chemicals are balanced properly. 

[KT0930]

When I was doing manual exchanges, I would line up three bags, place the heating pad on top of that, then put three more bags on top of that. When I used one from the top, I would move everything around and put a new one on the bottom. This way I always had a day and a half's worth of bags ready (four exchanges per day). Bags also had that full day and a half to warm up before I needed them, so they were ready when I was.

I was generally using 1.25% bags, but occasionally would need a 2.5%, so somewhere in the six I'd have one 2.5% just so one would always be ready. The heating pad would be kept on low, or else the bags got too hot, which was pretty uncomfortable going in and could also lead to scarring.