Blood transfusion and IV cannula.

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There is one post from an ICU nurse on the forum:

https://allnurses.com/blood-transfusions-how-fast-go-t111999/

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TWO bags of PRBC's and ran them both in at 500cc/hr. They were both infused (per #20 peripheral IV's) within 45 minutes ...

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A 20g IV cannula can allow approximately 60 mL/min or 360 mL/hr infusion rate.

How can 500 mL/hr be achieved through a 20g IV cannula?

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Specializes in Critical Care.

Recommended max flow rates vary by manufacturer and catheter, but for a 20G catheter it's usually around 5ml per second, or 300ml per minute. 500ml per hour would be well within the recommended flow rate maximum.

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32 minutes ago, MunoRN said:

Recommended max flow rates vary by manufacturer and catheter, but for a 20G catheter it's usually around 5ml per second, or 300ml per minute. 500ml per hour would be well within the recommended flow rate maximum.

There is a typo in the original post "A 20g IV cannula can allow approximately 60 mL/min or 360 mL/hr infusion rate".

The correct typing would be 3600 mL/hr.

I am not sure whether your reply "5ml per second, or 300ml per minute" is correct.

Is it really "300ml per minute"?

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Specializes in Vascular Access.

AU, you are correct. Most 20 gauge 1 inch IV catheters have flow rates of 60 to 65 mls A MINUTE. 60 ml x 60 minutes is 3600 mls/ hr. Milliliters per hour will vary of course, depending on gauge of the IV catheter.

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Specializes in Critical Care.
12 hours ago, Nursing Au said:

There is a typo in the original post "A 20g IV cannula can allow approximately 60 mL/min or 360 mL/hr infusion rate".

The correct typing would be 3600 mL/hr.

I am not sure whether your reply "5ml per second, or 300ml per minute" is correct.

Is it really "300ml per minute"?

Here are the Instructions for Use for a commonly available peripheral IV catheter, in the upper left are the flow rate capacities. The maximum flow rates for a 20g catheter range between 4 and 5.5ml per second, or 240 to 330ml per minute. Passive flow rates, aka gravity flow rates, are typically around 60ml/minute for a 20g catheter.

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It is a good document about Fluid Mechanics.

In real practice, perhaps a flow rate between 240 and 300ml/min would be too high.

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If blood transfusion is given via a PICC line, how much can the PICC line influence the flow rate of blood transfusion?

Certainly a specific infusion rate can be set up by IV pump.

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Put the bag of fluid inside a pressure bag or a rapid infusion pump and you can give a 2 bags of PRBCs or a 1000ml bag through a 20g in a much shorter time frame than 45 minutes. This is done fairly regularly in extremely hypotensive patients in ICU, OR and Emergency. Obviously a large bore access is preferrable and allows even faster infusion rates but the reality is in a crashing patient you work with the access you have.

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Specializes in Critical Care.

I've given 6 units of blood in 10 minutes, although, that was through an 18g.

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On 4/17/2019 at 1:11 PM, /username said:

I've given 6 units of blood in 10 minutes, although, that was through an 18g.

Massive Transfusion Protocol could be quite different from general blood transfusion guideline. It aims to improve patient survival regardless of potential risks. However, once the risk of TRALI arises, the transfusion nurse could be quite busy at work, if the nurse has a few other patients.

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