I had a patient who came in with an INR of 15 (due to Coumadin use). I gave Vitamin K sub-q. Besides an AV fistula that was scantly oozing, there were no apparent signs of hemorrhaging. The patient had an ischemic bowel and needed to undergo necessary surgery timed for 3 hours later. At the doctor's request, the patient needed several units of FFP transfused before surgery.
Because the blood bank took a while to prepare the blood, it was nearly 1.5 hours later until I could get ahold of a couple units of FFP; and just my luck, the FFP was going in slower than I thought. The doc said I can just run them in fast, and was okay with me transfusing 2 units simultaneously.
However, my charge nurse later checked in and said we really shouldn't be transfusing 2 units of FFP at the same time (because of transfusion reactions). My patient was fine before, during, and after the transfusions and after surgery. But I do now realize the risks had a reaction had occurred.
In my ICU, I've seen 2 blood products given simultaneously when patients are "crashing"; mine wasn't "crashing" but she did need the FFP.
Does anyone know the recommendations for transfusing blood products simultaneously?