*Blood Transfusion

Sleepyeyes · Jun 21, 2002

So it doesn't bring the patient's body temperature down too much.

My Lippincott Manual of Nursing Practice, 6th ed., p. 785 says:

"An approved blood warmer may be indicated to prevent hypothermia and cardiac arrhythmias associated with the rapid infusion of refrigerated solutions."

Hope that helped.

caroladybelle, BSN, RN · Jun 21, 2002

In Oncology, some patients show up with a 'cold' antibody - we are warned to use a blood warmer with these patients. I don't know the exact pathology involved - I just always use the blood warmer on those.

2ndCareerRN · Jun 21, 2002

In the ED we will run the blood through a Level I infuser for a massive transfusion. Massive being the replacement of more than 1 blood volume over several hours ( not 1 unit, 1 volume).

If just replacement of a few units, it goes in at room temp.

It is run through the infuser, and any other large volumes of fluid replacement to help prevent hypothermia.

If just infusing small amounts we will use warm blankets or a bear hugger on the pt.

There are a lot of things that can go wrong during massive transfusions, not just hypothermia. If you do a search on blood transfusions you will find a wealth of information.

BTW: Welcome back

bob

kewlnurse · Jun 21, 2002

Do you guys use gravity or pumps for transfusions? I think we are one fot he few places on earth that still use gravity, no proof that cells are destroyed by pumps form what I here. Than again were pretty assbackwards here

RNforLongTime · Jun 22, 2002

I have always run blood on an infusion pump. Especially with the elderly, don't wanna send em into CHF or Pulm edema.

oramar · Jun 22, 2002

Used gravity till about 88/89. Then special blood pumps came out at that time for blood only. Used those till about 93/94 when we got pumps that were good for all infusions including blood. Dates are approximate, might be off a little.

nowplayingEDRN · May 31, 2003

Originally posted by 2ndCareerRN
In the ED we will run the blood through a Level I infuser for a massive transfusion. Massive being the replacement of more than 1 blood volume over several hours ( not 1 unit, 1 volume).

If just replacement of a few units, it goes in at room temp.

It is run through the infuser, and any other large volumes of fluid replacement to help prevent hypothermia.

If just infusing small amounts we will use warm blankets or a bear hugger on the pt.

There are a lot of things that can go wrong during massive transfusions, not just hypothermia. If you do a search on blood transfusions you will find a wealth of information.

BTW: Welcome back

bob

That is basically how we infuse blood here where I work as well....in addition we monitor VS q5minx4 then q15x4 and every 30 min there after till the transfusion is completed, so we always know where we stand temp-wise.

Used gravity right up until about 1997 and when I can to the facility I am currently at, they used infusion pumps with special blood tubing. Haven't used gravity since.

rileygrl11, BSN, RN · Jun 23, 2003

Oh,....how I wished our hospital would allow us to use pumps. We still use gravity and are a large facility,.....go figure!

We do pre-transfusion V/S, 15 minutes into transfusion, then post-transfusion 1 hour after completion. I was surprised our policy is so infrequent, but maybe that is just my opinion.

ENDOgal · Jun 24, 2003

WE infuse quite a bit in Short Stay surgery, and use Horizon pumps and Y-filter tubing. Infuse @ room temp straight from the Lab. V/S are q15x4, then q30 till infused.