Running PRBC concurrently with NS?!

Nurses General Nursing

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  • by nurseap
    Specializes in Medical-Surgical/Oncology.

You are reading page 5 of Running PRBC concurrently with NS?!

Altra, BSN, RN

6,255 Posts

Specializes in Emergency & Trauma/Adult ICU.
I doubt a 22g would last very long if I had to run blood/NS at 195ml/hr for the time it take for 2 units to infuse.

Have you ever given a patient a fluid bolus? One liter in an hour or less? What's the administration rate then?

Here's a link to one brand of IV catheter. Note that the flow rate for a 22# catheter is 35mL/min. (2,100mL per hour)

https://www.bd.com/infusion/pdfs/D16128.pdf

If there are other links to information I can pass on please let me know. I'm not sure where you got the idea that the catheters themselves were so fragile.

squatmunkie_RN

175 Posts

Have you ever given a patient a fluid bolus? One liter in an hour or less? What's the administration rate then?

If there are other links to information I can pass on please let me know. I'm not sure where you got the idea that the catheters themselves were so fragile.

Experience...sure I've given boluses. Ive bloused (sp??) a unit of blood on a regular floor. The IVs don't last long after that. They leak...and infiltrate all the time.

Maybe it's the type that my hospital uses, but that's just my personal experience working.

Altra, BSN, RN

6,255 Posts

Specializes in Emergency & Trauma/Adult ICU.

Leaking & infiltration are related to the vein in which the catheter is in ... not the IV itself.

Specializes in Case Mgmt, Anesthesia, ICU, ER, Dialysis.

The size of the IV speaks to the resistance to flow overall. According to Pouseille's Law, decreasing the diameter of a flow tract by 50% will increase resistance by a factor of 16x's. Resistance in an IV also contributes to turbulent flow, (as opposed to laminar). If trying to infuse quickly through a smaller IV, it increases your chances of infiltration.

So you're correct when you say it's not related to the IV itself...directly. But it could be argued that there is an indirect correlation.

canoehead, BSN, RN

6,890 Posts

Specializes in ER.

OP, you did nothing wrong, and your coworker was nitpicking. Given a few years of experience you'll be able to say "Oh, really, I don't think that's true." and provide her with a reference or invite her to write you up. I notice that the old RN's on this thread are OK with NS and blood together...although most policies will stress not hanging anything with blood, they will also name NS as the ONE exception. If you think about the reasoning behind only using NS with blood you can see that hanging the two running together would work as well. If the pt had a reaction to the blood you'd lose about 20cc NS in the line...easliy replaced.

Vespertinas

652 Posts

Tell that RN II, "If you're trying to help me, you're being rude about it. I consult with my preceptor on everything I do and if you have a problem with it, you should speak with him/her."

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