blood transfusion tubing disconnected

[ARRR10]

I have a question about a situation that happened to me during my clinical. The patient was receiving her second pack of blood. I got the tubing ready and placed it into the IV pump along with the NS. The nurse I was assigned to doublechecked everything and saw that everything was going fine. After about half an hour, we went to check on the patient and the IV pump and we noticed that there was blood on the floor. The nurse thought that it was from the previous pack of blood, but then we noticed that the tubing in the IV pump was really leaking. So, what the nurse did was she got new IV tubing along with a new IV pump and sort of connected it back together again. Now, I am thinking- is it right to do that? Because the tubing that was leaking was open to the environment and I am thinking risk for infection, because the air outside is already exposed to the blood (it's suppose to be sterile right?) that the patient is receiving.

Also, I'm just curious what is the maximum amount of blood transfusions a nurse can have on her shift (1 blood transfusion per patient)? Reason I asked is because a nurse had a total of three blood transfusions she had to give (she had a 6 pt. load).

Sorry if my post is too confusing. Thanks

[masonRN]

Let me offer a few opinions:

Regarding the respiking of the blood...it's not ideal, but blood is not a plentiful commodity, and someone likely gave of their time and their body for the benefit of your patient, whom they would never meet. I would be cautious to be respectful for every last drop of the stuff, and would do my utmost to ensure effective use of all of it.

Clinically speaking, the blood leaked OUT of the tubing, so an infectious agent would have a tough time traveling from the outside of the tubing (which was sterile prior to its removal from the packaging), against the current, into the infusing blood (the same way the human body works, flushing contaminants OUT). While there is obvious risk for contamination, I would judge it as low, and would have done similarly.

Regarding a per-patient transfusion limit... I don't know of any institution that limits this, and I don't know if there is any reason to implement such a limit, for her or for him.

I once gave 2x PRBC, 2x Platelets and 4x Cryo Plasma to pt #1, 4x PRBC to pt #2, and titrated NTG, MSO4, and Insulin on a 3rd. Thankfully, that's not a "normal" shift for me.

[NotReady4PrimeTime, RN]

I once gave 2x PRBC, 2x Platelets and 4x Cryo Plasma to pt #1, 4x PRBC to pt #2, and titrated NTG, MSO4, and Insulin on a 3rd. Thankfully, that's not a "normal" shift for me.

That is a fairly normal shift for me, although I usually only have 1 critically ill patient. In one shift I have given 3 transfusions of PRBC, 10 units platelets, 4 units cryo, 2 units FFP and a vial of ATIII, along with 30 mL per kg of 5% albumin.