Blood transfusion

Nurses General Nursing

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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 ?:idea:

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Minimum time depends on the circumstance. There might be a hospital policy on this you need to check. If stable, without symptoms, I would give a floor patient the blood over 2 hours.

In an emergency, the rapid infuser can give a unit of blood in minutes depending on the size of IV access.

Lasix is pretty common after transfusion or between units. The patient may be at risk from volume overload even without a prior history of CHF.

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Specializes in Telemetry & Obs.

Minimum time is wide open (in an emergency)

You're right about the lasix :)

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Specializes in Peds, PICU, Home health, Dialysis.

Our hospital requires that blood transfusions be hung within 30 minutes after leaving the blood bank, and need to run over a 2 hour span.

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Specializes in critical care transport.

Can't your potassium go up too (maybe another reason for lasix) because RBC's sometimes break and release K+? The logical thing might be fluid volume overload like everyone seems to be saying, since they may have enough fluid, just not enough RBC's, and adding those RBC's and IV fluids would cause the body to hold on to fluid more.

I'm glad you asked it. Now I'm curious.

We have to have it infusing into the pt within 30 min. We have a hospital policy listed on the intranet.

My .02

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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 ?:idea:

And i have learnt i need to ask questions before i leave work coz ive been trying to find more answers the whole weekend

This patients BP on the left arm was 102/44mmhg and on the right arm was 99/56. HR 88. He was also getting D51/2 NS @ 50ml/hr. No edema. Everybody says its to prevent fluid overload but iam not satisfied with this answer. Going back to work tomorrow and i hope the pt is still there so i can find out from the MD who wrote the order if there is possibly another reason:idea:

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Specializes in Cardiology.

You infused blood and had fluids running. I'd say it's a risk for fluid volume overload. In time, you'll figure it out ;-)

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Specializes in med/surg, telemetry, IV therapy, mgmt.
1.what is the minimum amount of time you can transfuse one unit of prbc- i know max is four hours
in an emergency blood can be given with the clamps on the iv line wide open--10 to 15 minutes.

2. why give lasix after a transfusion
to prevent the patient from going into congestive heart failure due to overhydration as a result of the iv fluids given along with the blood.

there are weblinks to information about blood transfusions as well as a chart of commonly given blood products on post #6 of this sticky thread in the student nursing forums:

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Lasix is used to prevent FVO, and hypercalemia.

I work in renal/dialysis. Renal pts who have blood ordered are ideally given their transfusion during dialysis- for fluid removal, and prevetion of hypercalemia.

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Specializes in med/surg, telemetry, IV therapy, mgmt.
This patients BP on the left arm was 102/44mmhg and on the right arm was 99/56. HR 88. He was also getting D51/2 NS @ 50ml/hr. No edema. Everybody says its to prevent fluid overload but iam not satisfied with this answer.

You should be. Hypertension or edema, which is what you wanted to see, are NOT the only symptoms of fluid overload! There are others. The symptoms of fluid overload, or fluid volume excess (remember that nursing diagnosis?), are one or any of the following (page 91, NANDA-I Nursing Diagnoses: Definitions & Classification 2007-2008)

  • adventitious breath sounds (rales, rhonchi, wheezes)
  • altered electrolytes
  • anasarca
  • anxiety
  • azotemia
  • changes in blood pressure
  • change in mental status
  • changes in respiratory pattern
  • decreased hematocrit
  • decreased hemoglobin
  • dyspnea
  • edema
  • increased central venous pressure
  • intake exceeds output
  • jugular vein distention
  • oliguria
  • orthopnea
  • pleural effusion
  • positive hepatojugular reflex
  • pulmonary artery pressure changes
  • pulmonary congestion
  • restlessness
  • specific gravity changes
  • S3 heart sound
  • weight gain over short period of time

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Everybody says its to prevent fluid overload but iam not satisfied with this answer.

An inquisitive mind is an excellent quality! It may not seem to make a lot of sense to expect fluid volume excess with the volumes that you are administering. However, a patient receiving blood products is more likely to develop FVE because of the high osmotic load of the blood products.

High osmotic load basically means that you have a high electrolyte concentration, in part due to normal constituents of human blood and partly due to additives like sodium-containing anticoagulants added to donated products. Since water follows salt, IV infusions of this type of product will draw fluid into the intravascular space and predispose them to fluid volume excess more quickly than we might expect.

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I am looking for information on what the risks are of infusing blood over longer periods of time than the usual 4 hrs., 6 hrs to be specific. The only info I have been able to find so far are an increased risk of infection due to bacteria growth on the filter. Any & all information would be appreciated, thanks

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