Sick

xoemmylouox, ASN, RN · Dec 13, 2013

Shoot this is nothing to lose sleep over. Take some time to review your system and all of the lines. I'm sure you won't make this mistake again. Accept you're not perfect and move on :)

cardiacfreak, ADN · Dec 13, 2013

If you think losing sleep over blood is something, you should ask us what we have done to lose sleep. Betcha it is a whole lot worse.

I lost sleep over a med error (this was prior to using a scanning system), I obviously bypassed my 5 rights of administration and gave a patient IV Digoxin instead of IV Morphine. THAT was worth losing sleep, and yes thankfully, the patient was not harmed.

Saasy · Dec 13, 2013

Thanks everyone for the comments. To answer the questions posed earlier the saline backed up into the unit if blood making the volume too large to infuse under the 4 hour time frame blood is good for. I would have risked overloading him with fluid. This was a bigger problem than the pump Bottom line I should've taken charge and dealt with it rather than listening to others and it would have worked out. Lesson learned. Trust my gut from now on.

K+MgSO4, BSN · Dec 15, 2013

Not your gut, your education and training. Talk to your education team or blood nurse ( I have 4 of them in the hospital) they do education and awareness training. Grab a giving set a bag of saline and another bag of 'blood'. Go through the process until you are confident.

CrossCountryRN2008 · Dec 21, 2013

Why waste the blood? Also even on secondary setting the pump should switch over to primary if there is no secondary fluid up

KelRN215, BSN, RN · Dec 21, 2013

Thanks everyone for the comments. To answer the questions posed earlier the saline backed up into the unit if blood making the volume too large to infuse under the 4 hour time frame blood is good for. I would have risked overloading him with fluid. This was a bigger problem than the pump Bottom line I should've taken charge and dealt with it rather than listening to others and it would have worked out. Lesson learned. Trust my gut from now on.

How much saline backed up into the line and what was the patient's underlying diagnosis? Healthy kidneys can handle a LOT of fluid.

Saasy · Dec 28, 2013

How much saline backed up into the line and what was the patient's underlying diagnosis? Healthy kidneys can handle a LOT of fluid.

There was probably 600-700mls in the bag to get in 3 hours. Also I'm not familiar with diluting blood so the thought never really occurred to me and I wanted to be safe than more sorry than I already was.

KelRN215, BSN, RN · Dec 28, 2013

There was probably 600-700mls in the bag to get in 3 hours. Also I'm not familiar with diluting blood so the thought never really occurred to me and I wanted to be safe than more sorry than I already was.

Ok. So 600 mL over 3 hrs is 200 mL/hr. 200 mL is less than 8 oz of fluid... which your average adult can drink several times over in an hour. 600 mL is 20 oz... the equivalent of your average size bottle of water. Was this patient on a fluid restriction? It honestly doesn't sound like you were at risk of fluid overloading him. I am NOT trying to make you feel worse about this- what's done is done. I am just trying to get you to think things through. You can bolus a liter of fluid over 15-20 minutes for a patient who really needs it- healthy kidneys can handle it. Typically you don't dilute blood, but blood and saline are compatible so saline backing up into the line- in and of itself- is not a reason to discard the blood.