blood administration

[jennifers]

I'm a new nurse. I have worked on the floor only about two weeks. Anyway, my perceptor gave blood the other day off a pump. When i asked about it she said you could do it either way. I thought we always had to do it on a pump...anyway I think that was the way they trained us in school. I can't find the policy since i'm not at work right now. Just curious how everyone else did it. It was to be administered with NS. She just used that to prime the tubing. I felt weird about it but she has been a nurse forever. HELP

[KAYBDT6, BSN, RN]

She needs to be re-trained or go back to nursing school. I know you can only give through infusion pump and used NS for patency.

[NotReady4PrimeTime, RN]

Well actually, in our facility we specially-trained RNs are permitted to push blood and run it with or without a pump. The tubing isn't always primed with saline, it depends on what else is going on. It isn't run WITH anything else, but it's always flushed with saline only. (Dextrose causes hemolysis.) You really need to look at your facility's transfusion policies.

[NickiLaughs, ADN, BSN, RN]

At our facility you are allowed to either run through the pump or (after training) free flow the blood (without a pump). It depends on the facilitie's policy and procedures. (This is cardiac ICU by the way and we give blood often).

[caroladybelle, BSN, RN]

She needs to be re-trained or go back to nursing school. I know you can only give through infusion pump and used NS for patency.

Incorrect.

PRBCs/Platelets/FFP can be done on or off pump. In fact, there used to be some worry that pumps might damage the cells and therefore were usually given off pump. NS is used to flush/prime the line, and is also used as a standby, if a reaction occurs.

WBCs/Granulocytes in most places that give them (few places transfuse those) are done off the pump. Cryoprecipitate is off pump and on some units, it is pushed via special tubing and a syringe.

[RedCell]

She needs to be re-trained or go back to nursing school. I know you can only give through infusion pump and used NS for patency.

You do not have to give blood via a pump and you do not have to use .9%NSS. In fact, I usually dilute PRBCS with plasmalyte.

[WalkieTalkie, RN]

I routinely give PRBCs without a pump using wide-bore tubing and a pressure bag, if necessary. Depends on if the patient is crashing or not and other contraindications, such as CHF and renal status.

[ayla2004, ASN, RN]

we don't have pumps for blood tranfuison

[JStyles1]

ive never used a pump for blood. i used blood tubing with 500ml ns. i can have it in in around 10-15 minutes with something as small as a 22-20g

[ukstudent]

As you can see there is not just one way of giving blood, no matter what was taught in school. Some prime with saline, some don't. Some use pumps and some don't. On floors they are concerned about the 4 hour time limit, in a surgical ICU blood is often delivered to the pt in less than 15 minutes. So it will depend on what unit you work and the policy of that unit within your Hospital.

If you have any questions, especially concerning pt safety, you should be able to ask questions with your preceptor. Not is a negative way, such as "your doing this wrong", but in a I need to learn way, such as " this is different from how I have done this in the past, during nursing school. Could you explain why we are doing it this way"?

Welcome to the multiple correct ways of doing things in real nursing from there is only one correct way of doing things of nursing school. It's a steep learning curve. Good luck.