Blood transfusion question

[vhrn]

Another issue concerning blood transfusions:

I recently wrote in regarding running other IVF and gtts in the same peripheral angiocath with PRBC transfusion: Now, there is another issue. Not only will my hospital not allow IVF and gtts to run with PRBCs through a peripheral angiocath, which is correct, we got an email saying we cannot run PRBC or other blood products through a multilumen central line, with other IVF/gtts infusing through a separate lumen. I cannot find printed information online that clarifies this. Any suggestions?

[meownsmile, BSN, RN]

I dont know why they would institute that policy. That is what a triple lumen is for so you can infuse several things at one time. I can understand that you need to examine if there are iv fluids running through one port that they may need to be adjusted so the patient isnt getting to many fluids at one time, depending on their history and dx. But to limit use of a triple lumen when the patient is recieving blood is rediculous. Are you sure they dont mean for the initial period when you are evaluating for reactions?

[Tweety, BSN, RN]

I would go to the source, or to one of your educators and ask about this. Sounds like there may be some evidence out there to support their change of policy and I'm sure they wouldn't mind showing you if you politely ask. If you find anything please share with us.

[Blee O'Myacin, BSN, RN]

Another issue concerning blood transfusions:

I recently wrote in regarding running other IVF and gtts in the same peripheral angiocath with PRBC transfusion: Now, there is another issue. Not only will my hospital not allow IVF and gtts to run with PRBCs through a peripheral angiocath, which is correct, we got an email saying we cannot run PRBC or other blood products through a multilumen central line, with other IVF/gtts infusing through a separate lumen. I cannot find printed information online that clarifies this. Any suggestions?

I would definately check with your educator. I mean, what if you have propofol and levophed or TPN in the other two lumens and no peripheral access (say, a patient with weeping anasarca, intubated and sedated on the vent).

However, if I was giving a transfusion to a healthier patient, someone awake and alert and only getting intermittent IVs, I'd be more comfortable waiting the initial 15 minutes from the start of the transfusion to ensure there is no reaction before starting an IV med that has never been received by the patient. (Assuming of course that it is OK with policy to run through a double or triple lumen.)

Each lumen terminates at a different point in the vessel, so its designed to run meds that are incompatible with one another. So other than being able to determine a transfusion reaction from a drug reaction, I can't think of any other rationale for this.

And besides, any alert patient with a triple lumen is going to balk at the idea of having a peripheral IV started!

Blee

[EmmaG, RN]

Each lumen terminates at a different point in the vessel, so its designed to run meds that are incompatible with one another. So other than being able to determine a transfusion reaction from a drug reaction, I can't think of any other rationale for this.

My guess is that this particular facility had an incident (perhaps someone got the lines mixed up and ran something through a blood line) and this is their response.

[mtwife]

I echo the responses of inquiring with your educator. In many instances, this policy could harm the patient more than protect the patient: i.e: pressors, iv antibiotics, even prn meds would be "held" (unless blood is stopped and line if flushed) if said policy is as strict as it appears (it appears the intent is to ensure no solutions "mixing" w/ blood?) I'm sure multiple central lines in patients needing frequent prbc transfusions is not the ideal solution! Let us know!! :)