How fast is too fast to transfuse blood? - page 2

by RNdiva505 22,103 Views | 53 Comments

I have been trying to find a clearer answer to my question. I am a new nurse and new to transfusing blood. I know to get the blood in within four hour time period, vitals, priming, etc... My question has to do with rate and... Read More


  1. 4
    Quote from CerebralCRNA
    Also, the smaller the radius of the catheter will result in slower flow as flow is proportional to 1/radius (to the 4th power), which is derived from puiosselles law (8nl/Pi*r^4).
  2. 0
    Give it according to the Drs written (or verbal in an emergency)
    22g is too small to give blood through
    The rate will depend on the indication for transfusion- eg blood loss (will be given according to amount lost, lab values and rate of blood loss or anemia when it can be given over 2-4 hrs.If blood is to be given over less than a couple of hours (except in extreme emergencies when there may not be time initially) a blood warmer should be used to avoid shock.
    Blood can be given STAT using a pressure bag

    (they give blood transfusions to newborns and premies and small kids and you're sure not gonna get a 20ga into some of them

    This is a whole different ball game to adults and I would imagine that most neonates that receive blood transfusions will be in ICU
    and will probably have central venous catheters in situ.The blood has to be matched more carefully than for adults.
    If you give a neonate or infant a unit of blood you will kill it! The average circulating blood volume in a neonate is 85 TO 90 ML/KG INFANT 75 TO 80 ML/KG
    So for a neonate that weighs 8lbs or 3.6kg that's around 300mls.
    In neonates in cardio-thoracic OR we used to set up a blood warmer with transfusion set leading to a 3 way tap attached to one of the lumens of the central line and then then the anesthesiologist, could draw bllod from the blood warmer using a syringe and the 3 way tap and give it according to surgical blood loss.
  3. 0
    wow great info...thank u
  4. 2
    I have never understood the hemolysis issue with 22 ga catheters. Has anyone seen the how tiny the hollow fibers are in an artificial kidney??!! MUCH tinier than a 22 ga.

    I suppose I should look at the most recent research!

    But each unit needs to be run very slowly for at least 15 minutes, and then per your unit protocol or the doc's orders.
    NRSKarenRN and canoehead like this.
  5. 4
    Quote from merlee
    I have never understood the hemolysis issue with 22 ga catheters. Has anyone seen the how tiny the hollow fibers are in an artificial kidney??!! MUCH tinier than a 22 ga.
    And considering that we do blood draws with 23g. butterfly needles without hemolysis.
    hiddencatRN, kids, GGT1, and 1 other like this.
  6. 1
    Quote from Jenni811
    In other words a 2mm radius IV catheter compared 4mm radius IV catheter is going infuse 16x slower assuming that the length of the catheters are the same. The difference in the radius of the IV catheter cubed will give the approximate difference in flow rates between two IV catheters.
    NRSKarenRN likes this.
  7. 5
    Quote from merlee
    I have never understood the hemolysis issue with 22 ga catheters. Has anyone seen the how tiny the hollow fibers are in an artificial kidney??!! MUCH tinier than a 22 ga.

    I suppose I should look at the most recent research!

    But each unit needs to be run very slowly for at least 15 minutes, and then per your unit protocol or the doc's orders.
    I don't understand it either. On my unit, we give blood through 22s all the time. I was taught that the need for a larger gauge catheter to transfuse blood is a myth, so I'm surprised to see so many people agree that's it's the correct way to do things.
    tcvnurse, hiddencatRN, kids, and 2 others like this.
  8. 1
    Quote from Orange Tree
    I don't understand it either. On my unit, we give blood through 22s all the time. I was taught that needing a larger gauge catheter to transfuse blood is a myth, so I'm surprised to see so many people agree that's it's the correct way to do things.
    The potential problem is when you put it on a pump (too much pressure through a small gauge catheter can cause hemolysis) or if you ever wanted to give it faster than 2-4hours. In some cases with a 22g it maybe hard to get a bag of PRBCs in over 4 hrs with a 22g, but if you want to talk about myths and blood it is also a myth that only NS is compatible with blood. LR use with PRBCs is only a theoretical problem.

    http://www.dtic.mil/cgi-bin/GetTRDoc...f&AD=ADA421564
    http://www.springerlink.com/content/9hv712j8j2612v87/
    Esme12 likes this.
  9. 0
    Quote from wtbcrna
    The potential problem is when you put it on a pump (too much pressure through a small gauge catheter can cause hemolysis) or if you ever wanted to give it faster than 2-4hours. In some cases with a 22g it maybe hard to get a bag of PRBCs in over 4 hrs with a 22g, but if you want to talk about myths and blood it is also a myth that only NS is compatible with blood. LR use with PRBCs is only a theoretical problem.

    http://www.dtic.mil/cgi-bin/GetTRDoc...f&AD=ADA421564
    http://www.springerlink.com/content/9hv712j8j2612v87/
    OK, well the gauge with too high of a pressure makes sense. The LR thing is pretty interesting. I thought blood+LR= dead (or at least harmed).
  10. 11
    How fast the blood goes in depends on how fast it's coming out.

    Ahhhhh, the weekly catheter size vrs blood discussion...IMO. put the blood through the best access you can get, but don't delay a transfusion because the catheter is the wrong color.


Top