22 gauge IV cath in blood transfusions

SolaireSolstice, BSN, RN · Apr 19, 2009

My understanding is you SHOULD have 20 gauge or less for blood transfusions, but if all you can get in is a 22 gauge, you use what you can. The problem is that the smaller gauge will possibly cause hemalysis of the RBCs. The is no way special way to run blood into a 22 gauge. You use the same filtered line, etc.

deftonez188 · Apr 19, 2009

Last semester we had one of the day shift nurses running blood through a 22 - when the nurse I was working with noticed it she changed it right away stating basically what the person above me stated - hemolysis of RBC's - and if you're receiving blood i'd imagine you want it all intact! :) Yikes...

ZanatuBelmont · Apr 19, 2009

I'm on the hunt for information as to whether or not a 22 gauge IV cath can be used in blood transfusions. I seem to be finding conflicting information and my textbooks are no help (telling me to use at least a 20-gauge and that's all the info! ) From what info I've gathered, I'm guessing it can be used, but if so is there any special way of doing it? Thanks in advance for pointing me in the right direction! :bowingpur

My instructor told my class the other day the smallest to use is a 20, largest a 16. ::shrug::

Daytonite, BSN, RN · Apr 20, 2009

OK, I worked as an IV therapist for many years as well as a staff RN. Yes, you can use a 22g IV cath to infuse blood. However, it is not recommended. When a 22g is used, run the blood slowly, hang it high and do not use pumps because there is a greater chance of hemolysis of the RBCs. There are times when a 22g catheter is all you can get in a patient's veins.

BrnEyedGirl, BSN, MSN, RN, APRN · Apr 20, 2009

I was taught 20g or larger,..although I work ER and we use 16's and 14's in trauma's, as we are usually pushing it in as fast as we can. When I worked cardiac there were occasions when a 22 was all you had,.so we ran it slow and made do. Look at the needles your lab uses to draw blood,...they are usually 23g, so a 22 will not hemolize the blood if it isn't "forced" through the needle,.ie a pressure bag or a pump.

schroeders_piano, RN · Apr 20, 2009

When I worked peds we ran blood on 22g and even 24g. Run it slow. Have the bag spilt by lab so it will infuse in the alotted amount of time.

LovingNurse, BSN, RN · Apr 20, 2009

I was taught in school "nothing smaller than a 20 gauge", but several IV team nurses have said a #22 is fine if the situation doesn't call for rapid transfusion.

As with any IV, consider the situation and determine if the size is appropriate or whether they truly do need a larger size.

Here's a link that might be helpful: http://www.clinlabnavigator.com/transfusion/bloodadmin.html

mommiof2kids · Apr 20, 2009

i've always worked in peds. in a pinch i have given blood through a 24 gauge. in my personal experience the bigger iv you can get the better. in an adult a 20gauge iv would be adequate, 18 gauge preferable. with kids, take what you can get and watch the line like a hawk for s/s infiltration.

carolinapooh, BSN, RN · Apr 20, 2009

OK, I worked as an IV therapist for many years as well as a staff RN. Yes, you can use a 22g IV cath to infuse blood. However, it is not recommended. When a 22g is used, run the blood slowly, hang it high and do not use pumps because there is a greater chance of hemolysis of the RBCs. There are times when a 22g catheter is all you can get in a patient's veins.

I'll back this up. Sometimes on our floor we have pts that that's all we can get in them. (Chemo ruins your veins - all cancer pts should have ports but not all insurances will cover them - please don't let me get on my soapbox about insurance companies - and some of them have veins so bad you can't get a PICC/midline in them. And yes, many of those horrid chemos can be run through a PIV). We run it extremely slow and watch the vein carefully while we do it.