Adding NS to blood transfusion?

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Specializes in Critical Care, Capacity/Bed Management.

So I'm pretty sure I saw a nurse do this, when I questioned her further she got defensive... Can this even be done?

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I don't understand. What specifically do you think you saw?

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Specializes in Critical Care, Capacity/Bed Management.

A nurse added saline into the unit of blood...

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How?...

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Specializes in Critical Care, Capacity/Bed Management.

with the 500ml bag of NS that is hung alongside of the unit but kept clamped. The unit looked diluted and when I was going to take the patient for a test she said the unit was finished, to which i replied it looks like you got half a unit left and she replied by saying its finished she just added saline to get it going faster... I have never seen that before.

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Specializes in Mental health, substance abuse, geriatrics, PCU.

If you mean that the nurse added NS to the IV tubing with the blood or even ran NS with with the blood then yes that can be done.

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Was she infusing it by gravity?

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Specializes in Infusion Nursing, Home Health Infusion.

Yes you can add NS to packed cells if needed. Sometimes as blood ages it can have more cellular debris and the filter can become very saturated with the cellular debris so I would backflush some NS into the blood bag so I could complete the infusion. There is really no reason to routinely do it though and it might make it more difficult to determine how much was infused if the patient did have a reaction. It certainly is a lot easier and safer than having to re-spike the bag. It also helps if you make sure the 170 micron filter is primed all the way prior to starting the transfusion...so invert it to prime or squeeze until the NS covers the entire mesh in he filter and you still see the the blood drop into the drip chamber.

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Specializes in Trauma Surgery, Nursing Management.

I have seen anesthesiologists do this to get the blood in quickly. It kinda freaked me out at first too.

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Specializes in psych, addictions, hospice, education.

If she diluted it to get it flowing faster or more easily--that's one thing. But, if it was still hanging and looked diluted and there was half a unit of whatever still in the bag, then the patient didn't get all the blood if the infusion stopped at that point. Volume of fluid yes, blood no. If that's what you're saying she did, she shouldn't have done it. The entire bag-full should have been infused.

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Specializes in Critical Care, Capacity/Bed Management.

Thank you everyone for the replies!

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Specializes in Anesthesia.

I routinely mix my PRBC's with 0.9 NS in order to cut down on the viscosity. In the O.R. we don't use pumps for blood products and undiluted PRBC's will not "free float" even with the roller clamp wide open.

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