Questions about transfusions...

  1. I know there are many awesome nurses that read these boards, and I was hoping for some input on blood component transfusions @ your facility.

    1. How long should it take to infuse platelets? FF Plasma?
    2. Should you piggyback either one of these with NS?
    3. Do you use a filter with either of these? Special tubing sets?
    4. Do you need to have @ least a 20g. IV catheter for these?

    We transfuse alot of packed RBC,s but seldom platelets or FFP.
    (I plan to get with our lab director for more in depth guidelines. The ones we have are vague and seem incomplete.)
    Thanks for your help!
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  2. 9 Comments

  3. by   lever5
    FFP, fresh frozen plasma is a 200-300 cc bag and due to its volume needs to be infused according to your patients condition. Someone who has a history of CHF, you would go slower. Your hospital will have guidelines, FFP is usually infused with blood tubing which has a filter. Platletts often come in a six-pack, still a small bag and can infuse quickly due to the small volume. Again your facility will have their own rules about tubing and filters. You should try for a #18 or#20 gauge angio, but I have seen it done through smaller ones when no veins can be found.
    Last edit by lever5 on Feb 15, '02
  4. by   nurs4kids
    Platelets should run by gravity, wide open. The pumping action of an infusion pump will damage the platelets. Platelets can actually be pushed, but I've never pushed them myself. We don't piggyback ANY of our blood products with NS or anything else. If we have a reaction, then we have the option to start NS or HL the IV. To filter or not to filter depends on which product you're administering and how the lab prepared it. Most do require special tubing. We often give blood products through 24ga IV's with our babies.
  5. by   kewlnurse
    We run them both wide open, depending n the saus of the patient, we don' ususally pigge back them, run them to gravity and use the filter that is sent up from the blood bank, same as the prbc tubing.
  6. by   hoolahan
    Ditto all of the above.

    FFP can be given via your regular blood tubing, same size micron filter, but platelets require a special filter.

    FYI, usefulness of platelets as a coagulant agenct expires in 4 hours, after that, they can still be used for volume if need be up to 24 hours (that's what the blood bank told me once when pt came out of OHS with 4 units FFP unused, and didn't really need them either, what a waste!)
  7. by   RoaminHankRN
    Policy here for FFP; run in as fast as the patient will tolerate. Once FFP are picked up from blood bank, they can't be returned to blood bank after 20min.
    Also recommends the FFP be infused within 6 hours. I saw a single bag of platlets the other day that had 10 units. So many different policies for the same products. You gotta love medicine!!!

    Hank
  8. by   plumrn
    Thanks everyone! Very useful information. There is such a wealth of knowledge on these boards and, as I said before, some very awesome nurses!
  9. by   NRSKarenRN
    All blood products needs filters, special one for platelets. Agree with most of above info.

    Patients in ER/ICU type units generally will have FFP and platlets run wide open. Run little slower and with caution in CHF/transplant/Chemo and Peds patients.

    Many Patients getting Chemo/bone marrow transplant/Pediatrics will receive irradiated products. If platelet reaction, will use special Leucocyte reducing filter.

    Often Premedicate patients with PO/IV Benadryl with standing order if HX of reactions.

    Given LOTS Blood Products in ICU and in the home but last was 4 years ago when left IV agency.

    No longer standard to run NSS while giving blood but keep bag and tubing in patients room in case of Transfusion reaction.

    Here are some good sites with protocals:

    University of Iowa Blood transfusion protocols
    http://www.medicine.uiowa.edu/path_h....html#Platelet Transfusions

    NIHProcedure: Blood Products: Administration
    http://www.cc.nih.gov/nursing/bldprodp.html

    Blood Transfusion: Keeping Your Patient Safe
    http://www.springnet.com/ce/p708b.htm

    Blood Transfusions In The Home Sweet Home:
    How To Avoid A Sour Outcome
    http://www.moffitt.usf.edu/pubs/ccj/v4n4/report.html
    Last edit by NRSKarenRN on Feb 16, '02
  10. by   Lisah
    we run our platelets through a standard blood filter wide open and we do our vitals before half way through and at the end of the infusion. Our blood is run through the standard filter and on a pump with a main-line of saline.Our irridiated blood used to go through a Pall filter but that is no longer required only the standard filter.
  11. by   plumrn
    NRSKarenRN, thank you so much for the valuable links. I have saved them and will tell my co-workers about them!

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Questions about transfusions...