Blood back primed into NS... questions & I ooped

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Specializes in Mst.

I was completing a blood transfusion and all was well, not too experienced but got it from lab & ensured 2 nurse check was accurate and completed prior to transfusion. The patient wasn’t having any reaction, but at the half way point of my transfusion my blood had air in the line. I consistently primed the line without avail. I eventually started a new tubing line in the blood because the air alarm just wouldn’t start. As I was doing so some blood backprimed in the NS- oops. 

I called my charge over to inquiry about this. He told me the filter chamber should only be the 1/2 way of NS- which confused me, shouldn’t we ensure NS covers the top of the filter so blood doesn’t hemolyze- wouldn’t it hemolyze from the pressure of hitting the top of the chamber? 

He also said we couldn’t give the NS with some of the backprimed blood because it’s hemolyzed now and will cause hyperkalemia. He was also worried the patient would be fluid overloaded. This didn’t make sense to me because NS and blood products are compatible. Mind you, the patient was already receiving NS at 75 aside from transfusing so I could have ran the NS with backprimed blood in the 4 hour time limit frame 

does accidentally backpriming blood in NS hemolyze the blood and how much NS do we actually fill up the filter with? 

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Specializes in PICU.

Not quite sure if I understand completely what happened, but why are you hanging NS with a blood transfusion, this really isn't indicated.  NS typically should not be given along with a blood transfusion.  

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Specializes in ICU.

Are you saying that you hung blood in compatible tubing and then piggybacked NS to flush the line so tge patient receives the full.amount if blood? This is what I have done in practice. 

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Specializes in Mst.

I accidentally left the clamp open to the NS and the blood went into the NS

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Specializes in critical care.

I'm thinking the 250 NS on the Y wasn't clamped shut. Then the error may have occurred because either the blood and NS cont was running on the same IV access and the blood was slower than 75,  & behind the NS. they are safe to run together Florida

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Specializes in Critical Care/MICU.
On 11/20/2021 at 8:42 AM, RNNPICU said:

Not quite sure if I understand completely what happened, but why are you hanging NS with a blood transfusion, this really isn't indicated.  NS typically should not be given along with a blood transfusion.  

I thought NS and blood was compatible, and only fluid compatible with blood transfusion?

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