Check Hb post-transfusion?

[talaxandra]

We're having a little dissent at work tonight about how long to wait after a transfusion before taking a repeat FBE. At present the different positions are:

- at least half an hour

- an hour

- four hours

We'll be taking AM bloods regardless, but have a slip for an overnight FBE, too. Opinions?

[SonorityGenius]

Standard is 3-4 hours at our facility

[tablefor9, RN]

4hrs post transfusion, here

[WSU_Ally_RN, BSN, RN]

I've always been taught at least 1 hour post transfusion...

[mskate]

In the ICU, i usually wait 1hr post to re-check to see if i got an appropriate bump in the hgb for the number of units i gave.

[talaxandra]

The slip specifies 1/24 post transfusion - the patient came in with H&M, and we're thinking maybe they want a post-transfusion baseline (which will be around midnight) to compare with the AM Hb (which will be around 0800). The patient hasn't had haematemesis or malena for the better part of eight hours.

[ocean waves]

Hello. Yes, some doctors' orders are not always clear. I agree with the writers who imply checking with your lab department or your nursing supervisor to learn if there is a "norm" for post blood transfusion lab work with this type of order at your facility. Best wishes!

[Zookeeper3]

In our ICU, we recheck one hour after. Understand though, that our pre-transfusion levels maybe a hemoglobin of 4 and it's run stat. So it's a different animal. I have the next unit almost done before I get that result back... it's a waste of time IMHO to prove we are improving the numbers, when I have 4 units ordered to transfuse and labs in-between.

so take that standard with a grain of salt.

[Fins Up!, ASN, BSN]

Just adding to the discussion of PRBC's transfusions......how many of you give lasix between units if giving more than one unit of PRBC's?

Just curious, had a patient go into overload when I gave 2 units PRBC's but no orders for lasix inbetween...lesson learned to ask for lasix if appropriate or just ask. (Of course had to do the protocol for transfusion reaction, considering the symptoms that occurred.)

[Elvish, BSN, DNP, RN, NP]

We usually draw 4-6 hrs post transfusion on my unit.

[Zookeeper3]

Just adding to the discussion of PRBC's transfusions......how many of you give lasix between units if giving more than one unit of PRBC's?

Just curious, had a patient go into overload when I gave 2 units PRBC's but no orders for lasix inbetween...lesson learned to ask for lasix if appropriate or just ask. (Of course had to do the protocol for transfusion reaction, considering the symptoms that occurred.)

varies due to the BUN/Creatinine and the ejection fraction as well as the H/H lvl with the potential to cause an MI due to volume depletion.

[Fins Up!, ASN, BSN]

thanks zookeeper3