blood transfusions and choosing the right port

Babs0512 · Nov 23, 2008

The rational is that if the patient was to have a reaction to the blood, and you had to stop it quickly, you could open the IV wide and only the little bit of blood from the Y site to the patient would infuse, however, if you had the blood infusing from say, the Y site closest to the blood, then the entire IV line of blood would have to infuse before you could give medications.

That is the reason I was taught.

Roy Fokker, BSN, RN · Nov 23, 2008

And are there any other instances (certain IV meds or treatments) that would require using the most proximal port as well?

Any medication that requires a rapid IV push (Adenosine comes immediately to mind)...

cheers,

iluvivt, BSN, RN · Nov 24, 2008

It really depends on what kind of line you are using. I am assuming from your question you are talking about a CVC or PICC. If you have a multi-staggered tip design. (ie the arrow percutaneous temporary CVC placed via the IJ or the Subclavian) you may actually want to consider the distal lumen and not the proximal. The distal lumen is the largest lumen (16 gauge) and since blood is so viscous this is an obvious choice....but the proximal or medial lumen (this is a triple lumen here) are both 18 gauge and work well too. The most important things to remember here is that if you are drawing blood from this type of device always draw from the proximal lumen and use the distal lumen for TPN.

Now if you had any open-ended PICC they are not a staggered tip although the lumens are still separate. So you can use any lumen for blood,but once again with a triple lumen PICC the distal will always be larger. The Groshong PICCs virtually have the same tip exit location....it is only about 1/2 cm difference. So in summary if you have something as viscous as blood...pick the larger lumem