Infusing medications with blood

[smshelby]

Soooo, I was visiting a friend in the hospital last night and she was there for severe anemia s/p an EGD the day prior so suspect a bleed from the bx done then. When I visited she had RBC's at 100/hr NS at 80/hr and a Protonix Gtt at 10/hr ALL GOING INTO THE SAME IV SITE. No central line or picc, just a regular PIV. No adverse affects that I'm aware of, anyone heard of this practice??

[Simply Complicated]

I thought that nothing could be hung with blood, as it can cause it to hemolyze?

[tmartin83]

Nope, never heard of it... I thought you ran blood by itself.

[Orange Tree]

I don't know if it's harmful, but I would be terrified to see it (or especially to do it).

[I<3H2O, BSN, RN]

I would never ever ever run any medication with blood. In my practice, it is NS and nothing else!

[LouisVRN, RN]

Nope, wouldn't do it and would have asked the nurse to see a policy where that was okay.

[xtxrn, ASN, RN]

New one to me... I had 25 units of blood products last year...never saw them hang anything w/blood- other stuff would have to wait. :)

[canesdukegirl, BSN, RN]

Running blood with Protonix changes the osmolarity of the solution, making it hypotonic in nature; thus leading to red cell hemolysis. Good call, Simply!

Blood should always be administered with only NS, and if another drug needs to be given, another line should be started.

Another rationale for giving blood separately as opposed to concurrently with another drug is that blood transfusion reactions happen. If you are giving another drug WITH the tx, how can you delineate a blood tx reaction from a drug allergy?

[MrChicagoRN, RN]

That would not be my first choice.

I'd see if the med could be rescheduled, or try to time the blood admin before or after the med.

[NickiLaughs, ADN, BSN, RN]

That would not be my first choice.

I'd see if the med could be rescheduled, or try to time the blood admin before or after the med.

It was a protonix drip, so it would be continuous. I think it would be time to have a second IV or consider a PICC. Hopefully someone caught the error!

[nowim clean]

Was it by any chance a triple lumen? We have used them in the ed and in Icu, this allows one stick but three accesses. Not sue how it would affect the blood though.

[nurseprnRN, BSN, RN]

"was it by any chance a triple lumen? we have used them in the ed and in icu, this allows one stick but three accesses. not sue how it would affect the blood though."

a triple- or double-lumen line would be perfectly acceptable to run blood through the largest lumen and other fluids thru the other one(s). the reason is that the iv fluid dripping into a running vein is less fluid per blood amount than blood running into an iv of other fluid, making for less hemolysis. a single-lumen picc would not be acceptable for the same reason piggybacking blood and fluid (except ns and maybe lr, but lr isn't used much lately) is unacceptable.