FFP infusion

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I have been trying to find recent info about this and it's driving me crazy because I'm getting conflicting info r/t infusing plasma. I had an order to infuse 3 units FFP's on an 81 female last night. I infused them over about 30min/unit, and administered IV Lasix after the last unit per MD orders.

My question(s) is:

Was it okay to infuse via 22g IV cath? And over the 30mins?

Keep in mind, she is in her 80's. And I've read that some people don't use pumps, but on the floor (non-ER, for example) we use pumps for basically everything at the hospital I work, and I used a pump like any other time for any other blood product I've administered. I've also read the rationales that for venipunctures, we use butterflies that are 23g or even 25g for lab draws. And for peds, smaller angios are generally used. Generally when we do PRBCs, we prefer 20g as the smallest.

I am worried sick that I dropped the ball by not placing a 20g, mainly because the dayshift RN I gave report to was questioning this and made it seem like I did something wrong (which I hope I didn't and I need your help!). I can't sleep and I'm stressing myself out.

Pt has cirrhosis, hep, and ascites. She tolerated all three units, no s/s of reaction. VSS (bp increased from SBP 100's to 120's), but not elevated, and to be expected).

I'm sorry this ended up long, but I really appreciate some info here. I've been a nurse for about a year and a half and it seems whenever I start to gain some confidence, something happens to throw me off or question myself/stress (but that's a different thread ;)

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Specializes in Emergency & Trauma/Adult ICU.

The 22-gauge is fine. Personally, I do prefer to try to have at least 2 IV sites if I'm going to be infusing something over a longer period of time, to cover the possibility that the patient may need another IVP med in the meantime - pain or nausea med, etc.

Your chosen rate of infusion seems ok, although I really can't answer that specifically without knowing the patient.

You did fine. :)

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Specializes in LTC Rehab Med/Surg.

Where I work it's policy to infuse the FFP over 3-4 hrs unless the MD orders differently. We treat the PRBC and plasma the same as far as infusion time.

If the pt had a 22 gauge, I'd have used it too.

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I second Altra's post above. You can definitely run FFP in a 22g., and one unit over 30 minutes is a standard rate. You did just fine!

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Where I work it's policy to infuse the FFP over 3-4 hrs unless the MD orders differently. We treat the PRBC and plasma the same as far as infusion time.

If the pt had a 22 gauge, I'd have used it too.

The MD ordered for each unit to be infused over 30mins (at my facility, platelets and plasma are around 30mins and PRBCs are over 3-4h).

And I'm breathing a bit easier right now. Thanks everyone.

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Specializes in ICU.

I've never heard of infusing plasma over 3-4 hours- ours usually takes 15-30 min, just wide open, and yes a 22 is fine; there are no RBCs to worry about breaking apart in a small gauge IV.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

FFP can be infused over 30-120 mins. 3-4 hours is a long time for FFP. A 22 gauge is fine. Blood can be infused in a 24 in peds.

Here is the Red Cross blood reference guide....][h=3]Administration - American Red Cross[/h]

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Specializes in ER, progressive care.

FFP is usually given wide open/within 15-30min. We don't put ours on the pump because the FFP tubing isn't compatible with it.

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Specializes in Emergency.

OP, sounds like you did just fine. It is important to remember the indications for FFP. It makes no sense to run it slowly, you want to get it in so it can do its work!

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Specializes in critical care, neuro.

22 gauge is fine. That nurse you gave report to needs to chill.

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Specializes in Pediatric/Adolescent, Med-Surg.
22 gauge is fine. That nurse you gave report to needs to chill.

Many people want a large bore IV for blood product administration but really you use whatever you have, and in an older pt like that a 22 may realistically have been the best. I wouldn't worry about it

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Specializes in Med Surg.

Take a look at your facility's policy on blood administration. Ours specifically states a 22 is acceptable for transfusions on an adult.

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