Blood transfusion

[blessed02]

1.What is the minimum amount of time you can transfuse one unit of PRBc- i know max is four hours

2. Why give lasix after a transfusion

For example had a pt with an order of 2 units PRBC'S. Give lasix 40 mg after first unit. Pt had a DX of Gi bleed and chronic anemia, H/H 6.1/18.1.

I am a new nurse- 3rd week on my own. From my workmates/google it seems its to prevent fluid overload. Pt has no chf. Any more info ?

[justiceforjoy]

Bacterial growth as well as the RBCs actually breaking down. No point infusing dead cells!

[canadiangradschoolrn]

At my hospital, the protocol is to infuse over 4-6 hours, so 6 hours is not too long, anything about that, you will have to think about the efficacy of the treatment, the risk of infection.

[Murse901, MSN, RN]

https://allnurses.com/general-nursing-discussion/6-hour-blood-419512.html

[emmanuil]

how much time from you recieve the unit must it be infusing?

[ZippyGBR, BSN, RN]

how much time from you recieve the unit must it be infusing?

30 minutes from the fridge to infusing , max of 4 hours to infuse, realistically the time from fridge to vein is less than that even if you have to go to the fridges 4 floors from the unit

[sunnycalifRN]

Agree with the 4 hr maximum time out of the fridge. We usually give blood over 60 to 120 mins so we never push the time limit.

[OCNRN63, RN]

We've got 15 min from the time the blood hits the floor until it hangs. It can't hang longer than 4h. I've worked in several facilities and never heard of letting blood hang longer than 4h. We usually infuse over 2 1/12h unless the pt. has cardiac issues.

[Esme12, ASN, BSN, RN]

how much time from you recieve the unit must it be infusing?

....

Infusion guidelines.......

http://tinyurl.com/3r34c2v

[MunoRN, RN]

....

Infusion guidelines.......

http://tinyurl.com/3r34c2v

Google's great and all but it's not exactly the go-to source for practice info without some serious filtering. The first result that gives time requirements says you have 6 hours to start the transfusion after it comes out of the fridge and another 6 hours to infuse it, which is 3 times the time limit given by the CDC as a category 2 recommendation.

[carolmaccas66, BSN, RN]

Have infused a lot of blood over 2 hours.

I suppose if you take longer the cells die and it clots up so you can't infuse it over long periods? Dunno I've never worked in haematology.

[Five&Two Will Do]

I try to aim for the 175ml/hr rate if it is not emergent. With good access that is not a problem. When we get one of those fun massive GI bleeds, we have used pressure bags to pump it in as fast as we could(DIC).

[Biggirl71]

I am employed in the Quality department of an LTAC. We use contract dialysis nurses to come in and perform dialysis on our patients. I am reading through a chart today and I find out that she infused 2 units of blood in less than a half hour on a patient with a BNP of 1555! Clearly the patient was in CHF. The patient's H&H was 8/25 so there was no need to rush the transfusion. The patient also had 4+ pitting edema of the bilat lower extremities. I am researching the standard for transfusions during dialysis because I don't know what they are. I know as a floor nurse, the standard minimum time for a single unit to infuse is 2 hours but could go as long as 4 hours based on the patients' status. The reason Lasix is ordered between units is to prevent fluid overload. Because this patient is on dialysis, I am not sure how effective the loop diuretic was. . .the nurse did not document her outputs via dialysis or foley! Needless to say, the patient ended up in respiratory failure and fortunately made it through the code. Now she's sucking on a vent. Does anyone have legit info that I can further research? I would like to prevent this from happening in the future. Part of my job is to identify what went wrong and put processes in place that will correct this and keep it from happening again. Thanks. . .