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Blood Transfusion: Confused on the whole situation. Input?

Has 1 years experience.

SO I get a new patient direct admit from home, dx: colon mass, anemia. I don't have any orders yet but my charge nurse tells me to go a head and get a SL in the pt. So I go and get a 22g the pt. is content. Then the nurse walks in after i'm done dressing the IV site and hand me a blood transfusion consent form. Shift changes @ 1500 and I lose the pt. and pick up 2 different pts. While giving report on my blood transfusion pt, I state that she has a 22g in the right FA, both the charge nurse and the nurse receiving pt start saying why doesn't she have a 20g? I'm new at nursing and I've only transfused blood once to a PICC line. I didn't know it had a be a 20g. Anyways to make the long story short the pt. ended up getting another IV. I felt completely stupid. Once I got home I read where you can give blood through 22g but you have to run it a little slower. Confused on the whole situation. Input?

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 14 years experience.

My workplace's policy forbids nurses from giving blood through a 22 gauge IV site. Here's the rationale: a 22 gauge is a small IV catheter. It is so small that some of the blood cells might become damaged or lyse during the passage through the catheter into the body.

At my workplace, we must use larger peripheral IV access per policy. 20 gauge (or larger) is acceptable because the blood cells are far less likely to lyse.

same if you were working in ICU....

the patient may not need blood or rapid fluids at all....but "just in case"....they want to be able to run them as quickly as possible.

i wouldn't fret too much. lesson learned, right?

applewhitern, BSN, RN

Specializes in ICU. Has 30 years experience.

This has been debated off and on over the years. One teaching hospital I worked at didn't care about the guage, claiming since a red cell is only 4 microns, a smaller guage would be fine. Other hospitals want an 18 guage. The hospital I work at now wants a 20 guage, and we have to have a doctor's order to use a 22. Just do what your hospital policy is.


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