Quote from nativesundance
we had quite a debate about the administration of blood products the other night at work which became unusually heated. so i put the question out to all of you...
1) how fast do you run your prbc's? what type of tubing do you use? what size of angiocath do you run it through? this subject in particular was hotly debated.
2) how fast do you run your ffp? what type of tubing do you use and through what size angiocath? do you use a pump?
3) how fast do you run your platelets? what type of tubing do you use and through what size angiocath? do you use a pump? this subject was also hotly debated.
4) do you feel there is any difference in cell integrity when running your (trauma-emergent) blood in using a pressure bag as opposed to using a rapid infuser/warmer?
it will be interesting to see what some of your opinions might be!!
1. depends on why they are getting the blood, what their vs are, and any pmh. anything from as fast as possible, to 3+ hours. preferably use an 18g, though a 20 can be used. some hospital policies allow use of a 22g. the smaller the angiocath, the slower the blood needs to be infused to avoid hemolysis.
2. ffp is infused wide open (unless there are potential fluid-overload issues), on a pressure bag if needed. it is infused with the tubing provided by the blood bank ("blood component tubing," not the same as prbc tubing). angiocath size doesn't matter. the tubing provided by our blood bank can't be used on a pump.
3. platelets -- same as ffp
4. no. and many facilities don't have a blood warmer/rapid infuser.
some pumps (old ones) can't be used to infuse prbcs. they crush the cells.
much of this stuff is very facility-specific, depending on their policy. i worked in one place where is was considered a med error if blood was hung to gravity, rather than on a pump. i left and went to another facility where it was impossible to run blood on a pump, since the tubing wasn't compatable with a pump. some of it depends on particular equipment, or even the theories/desires/ideas of the medical director over the blood bank.