Blood administration help

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Blood administration is one of the skills I have todo for check offs this semester and our teachers are unavailable to help with explainin the steps. They told us to watch a video that was done, but I am confused about some parts and really want to get it figured out. The part I'm not sure about is the white flow regulator and switching to normal saline after the blood has finished. Does the white flow regulator need to be pushed in when you put the cassette in the pump? And when you open the ns clamp to let it run after the blood do you have to reset the rate? Thanks to anyone who can help me out here.

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Specializes in Med Surg.

It all depends on the pump (or gravity) system you are using. On my floor we run RBCs as a piggyback, with the NS as the primary line. We program the pumps so they automatically switch back to the primary once the blood is finished. Does that help?

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It all depends on the pump (or gravity) system you are using. On my floor we run RBCs as a piggyback with the NS as the primary line. We program the pumps so they automatically switch back to the primary once the blood is finished. Does that help?[/quote']

I don't think that's how they have it set up in the lab. They mentioned something about going by the back of the box for the blood administration set to get the rate of the ns. I'm pretty sure it was 80ml/hr, but not positive. I am going to the lab to practice today and hopefully can get some help from other students. I don't think anyone knows for sure though. It's kind of frustrating, but thank you

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We have a Y set up, after blood is done, we clamp blood, unclamp NS, squeeze NS into filter chamber, and run in at same rate ad blood.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Blood administration is one of the skills I have to do for check offs this semester and our teachers are unavailable to help with explainin the steps. They told us to watch a video that was done, but I am confused about some parts and really want to get it figured out. The part I'm not sure about is the white flow regulator and switching to normal saline after the blood has finished. Does the white flow regulator need to be pushed in when you put the cassette in the pump? And when you open the ns clamp to let it run after the blood do you have to reset the rate? Thanks to anyone who can help me out here.
Why are your instructors unavailable to help? Isn't it their job to teach you?

blood1363498215674.pngLook at this picture....there are 3 clamps. One right below the Saline and one right below the blood and one below the filter/drip chamber.

The rolling clamp below the drip chamber is your rate regulating clamp...that remains essentially unchanged once your rate is set.

Take your blood administration tubing....close all clamps. Attach your 0.9ns to one side of the y tubing. Unclamp the clamp right below your saline. Gently fill the filter/drip chamber to manufactures specifications.

Slowly then unclamp the roller clamp below the drip chamber to flush tubing and remove air. Once flushed. Close roller clamp below the drip chamber AND the roller clamp below the saline.

Once again assure all clamps are closed. Check the blood according to policy....usually 2 nurses check blood against blood bank, blood bank papers and patients ID bracelet.

Once blood is properly identified.....make sure all clamps are closed. Attach blood unit to available side of y tubing slowly open roller clamp on the y tubing on the side of the blood then slowly open and set the roller clamp below the drip/filter chamber.

Take vital signs according to policy. Usually q 15 mins x 2, q1hour x 1 and at the end of the infusion approx (but no longer than) m4 hours later.

When administering PRBC, infuse the first 25 ml slowly over 15 minutes, staying with the patient to observe for any signs and symptoms of adverse reactions. Once you’re sure the patient is tolerating the transfusion, a unit of red blood cells can generally be infused over a period of 1 1/2 hours. Infusion rates are based on the patient’s blood volume, cardiac status and hemodynamic condition. Patients with who have lost a lot of their blood volume can tolerate blood administered as quickly as possible. Otherwise healthy adults with chronic anemia can be given red blood cells safely at a rate of 3-4 ml per kilogram per hour, while patients with cardiovascular compromise may tolerate rates of no more than 1 ml per kilogram per hour. Monitoring lung sounds for rales (or "crackles") is a good tool to observe for fluid overload. Infusion of PRBC must be completed within four hours after they are removed from the refrigerator, due to the potential for bacterial growth.

ResourceNurse.com Transfusion Basics

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Thank you all. Very helpful.

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