Transfusion too fast? - page 2

What is the quickest you have run in a unit of packed RBCs? The doctor ordered a unit to be given over an hour's time. This scared me. I called Critical Care and they said they didn't remember... Read More

  1. by   cmo421
    Quote from Butternut
    What is the quickest you have run in a unit of packed RBCs? The doctor ordered a unit to be given over an hour's time. This scared me. I called Critical Care and they said they didn't remember giving any that fast and if they had, it had been many years ago. I ran it at 200 cc/hr and stayed with the pt for over thirty minutes. Lungs remained clear. BP improved. So actually it ran in in an hour and forty minutes.

    She had been seeping slowly from a previous above knee amputation incision/infection/open areas. He is taking her back to surgery "tonight or tomorrow". The stump looked discolored to me and she has MRSA in it. Diabetic.

    Thanks for your input.


    If u r on a med surg floor,and someone needs blood that fast,they should be moved to at least a tele unit. ICU,trauma,post ops give blood fast all the time. On the floors alot depends on age,cardiac status and medical hx. The blood centers recommend blood infusing in under three hrs in most cases and always under 4. The warmer it gets ,the more issues with contamination and breakdown. Follow ur unit policy and get the pt to tele if they need blood that fast.(or an icu)
  2. by   Altra
    We always run it wide open.

    I'll exclude the situations with a pressure bag and/or rapid infuser for the sake of this discussion, as that's clearly not the scenario the OP describes. Wide open a unit runs in in 30-60 minutes, depending on the line.
  3. by   Tweety
    One hour is not that fast. But in a non-critical symptomatic patient I usually take 2 to 4 hours, depending on their age and condition - young folks I tend to go faster than older folks.
  4. by   Christie RN2006
    Quote from bigsyis
    Exactly-sometimes two units going into two separate lines simultaneously using the pressure bags in a trauma.
    Yep, I have done the above while also hanging FFP, albumin and pushing NS into other lines. Gotta love traumas!!
  5. by   leslie :-D
    unless it was life/death, i wouldn't run it less than an hr on a brittle diabetic, unless they had tele.

    leslie
  6. by   EmmaG
    Quote from bigsyis
    Exactly-sometimes two units going into two separate lines simultaneously using the pressure bags in a trauma.
    I awoke from my emergent cesarean (abruption) with one going in each arm. But I agree with the above; if they need it that fast, then they're critical enough to be monitored.
  7. by   meandragonbrett
    Umm...i only hang blood on pressure bags and with the rapid infuser.
  8. by   rn undisclosed name
    Quote from cmo421
    If u r on a med surg floor,and someone needs blood that fast,they should be moved to at least a tele unit. ICU,trauma,post ops give blood fast all the time. On the floors alot depends on age,cardiac status and medical hx. The blood centers recommend blood infusing in under three hrs in most cases and always under 4. The warmer it gets ,the more issues with contamination and breakdown. Follow ur unit policy and get the pt to tele if they need blood that fast.(or an icu)
    I don't understand - why tele? I work tele and I have never given blood like that. If the docs were wanting me to do that off to the icu we go. We don't even take any active GI bleeds - they are automatically icu material. Maybe we are spoiled compared to some hospitals. I dunno.

    To the original poster I always run blood over 4 hours. My patients have always had CHF or been renal. The only time they have gotten it quicker was if they were renal and getting it with dialysis and the tech/rn doing dialysis infuses the blood. I usually also give Lasix in between for fluid overload.
  9. by   cmo421
    Quote from kellykul
    I don't understand - why tele? I work tele and I have never given blood like that. If the docs were wanting me to do that off to the icu we go. We don't even take any active GI bleeds - they are automatically icu material. Maybe we are spoiled compared to some hospitals. I dunno.

    To the original poster I always run blood over 4 hours. My patients have always had CHF or been renal. The only time they have gotten it quicker was if they were renal and getting it with dialysis and the tech/rn doing dialysis infuses the blood. I usually also give Lasix in between for fluid overload.

    I said at least a tele unit. Many tele units r like mini ICU's depeding on where u work. Like I said,check with ur unit policy and get the pt to where they belong.
  10. by   DeLana_RN
    In dialysis we can give it faster, over 30-45 min or so.

    Of course, we give it on the machine and have excellent access (CVC or 15-ga needles); we can also increase the ultrafitration (fluid removal) rate to compensate for the additional volume infused.

    Typically, we transfuse 2 units PRBC's.

    DeLana
  11. by   canoehead
    Wide open. If you can see it coming out faster than it's going in that's a bigger health risk than fluid overload.
  12. by   bigsyis
    Quote from Tweety
    One hour is not that fast. But in a non-critical symptomatic patient I usually take 2 to 4 hours, depending on their age and condition - young folks I tend to go faster than older folks.
    On the floor I hung it as Tweety describes. Our hospital policy was that the unit had to come down after 4 hrs and an incident report had to be written about why the infusion wasn't complete in that length of time!
  13. by   micker14
    Does your unit have a policy in place for the Level One infuser? i need to come up with a policy for my unit and wanted to see what other hospitals have in place.

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