Blood transfusion

[NewlyGradBSN]

Just wanted to get your opinions on this. I currently work in the medsurg unit. We have this patient for transfusion of half of fresh whole blood. Her hgb levels were in the 90s mark. She had cancer as well and her weight was estimated at 70kg. Her transfusion was ordered for four hours, so by protocol i identified the patient correctly, i infused the blood slowly at first to monitor for reactions. At the second hour mark, i saw that my blood was still 3/4 despite constantly regulating. The blood as consumed at the 5th hour. At the end of the bt, patient's vs increased and dob was noted. Dr were informed and they gave furosemide and neb after. Bt rate was decreased to 6hours. My questions are: what is the safe rate of blood transfusion per volume? For example, was it safe to infuse it longer than 4 hours and or lesser than 4 hours?

[vnguyen3]

4 hours was the max time we could hang 1 unit of blood. I've never had problems with congestion, but If the patient has some kind of underlying conditions like CHF, then I'd let the MD know so we can have some type of established orders...just incase things go south...

[jannjul76]

Four hours is the max

[iluvivt, BSN, RN]

The maximum time that blood can be infused over is four hours. You can find this information in the American Association of Blood Banks (AABB) Technical Manuel. Hospital blood protocols use their recommendations to write policy and procedure. It is NOT clotting that is the concern here as stated by a previous poster as there are many types of highly effective anticoagulant systems that are available to be used in processed blood. It is rather potential bacterial proliferation and a greater risk for infection that the hang time is limited to four hours. If the patient needs a longer hang time the blood can be placed in smaller aliquots.

[RoamFreeRN]

Yep, 4 hours max. Lasix in between units for CHFers. if it has to run really slow then I've had docs order half units...1 unit = 4hrs whereas 2 half units= 8hrs.

[Miss Kitty00]

Agree with everybody else. Anywhere from 2 to 4 hours. I usually run units in a shorter time than 4 hours. The only time I run it to reach 4 hours if the pt is elderly, has CHF or renal failure.

[classicdame, MSN, EdD]

Talk to your Blood Bank medical director. Ours is very accessible. We use the American Blood Bank standards for policies related to infusion of all blood products. Their recommendation is