Blood administration and lasix

[Tiya4]

Hello!

So I graduated a few months ago and passed the NCLEX (yay) and am currently working on a medical/palliative floor.

So the other day I was doing a blood transfusion and had to give a large dose of lasix between 2 units. I forget the exact dose but it was more then I could give IVP by our policy. So the blood transfusion was finished and the line was flushed with NS. I then went to hang the lasix as piggyback on the same line that the blood had been run through. The lasix would have been connected lower then the filter in the blood line. A family member of the patient was there and happened to also be an RN and informed me that I had to prime a new line to run the lasix. So I did that and thanked her for pointing that out. She then filled an incident report on it and it became a little bit of an ordeal and I have been thinking about it since.

Anyways I am just wondering what the issue really would have been with doing that. The filter was above the place that I connected the piggyback of lasix and the line had been flushed with NS (although there was a small amount still hanging out in the line). What is really the science behind it? I looked through the hospital policy and couldn't actually find anything saying I could not do that and I searched through my textbooks and can't find an answer either.

Thanks!

[Anna Flaxis, BSN, RN]

The filter was above the place that I connected the piggyback of lasix and the line had been flushed with NS (although there was a small amount still hanging out in the line).

Am I correct in assuming that you mean that there was a small amount of red blood cells in the tubing?

What is really the science behind it?

Think about the science behind why we do not add anything to a blood transfusion other than the 0.9% normal saline used for priming and flushing the line.

Now imagine that there are still red blood cells in the tubing that you're infusing the Lasix into.

What possible complications could occur?

[KRVRN, BSN, RN]

I'm imagining RBCs in the tubing with the lasix and I'm not sure what's supposed to occur either.

[Sour Lemon]

I'm imagining RBCs in the tubing with the lasix and I'm not sure what's supposed to occur either.

Me either ...I've always given it through the same tubing. My doses have always been push though. I don't think I'd do it piggy back ...but only because I never piggy back anything with blood.