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??

[carolmaccas66, BSN, RN]

At our facilites, blood can only be run by itself. We are not allowed to run other fluids simultaneously. Nurses should always check their facilities policies re this before commencing any blood.

I myself have never heard of this.

[Simply Complicated]

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?

That was my other thought. I know usually when you have a reaction, you have to send tubing and all to the lab for testing.

Sounds like someone didn't know what they were doing. I hope someone caught that!

[Lifeofanurse]

We were taught NOTHING runs w/ blood beside NS or LR. and on that note. We are LVN ...so we don't hang it either. We can check the cross matches and monitor for reactions but no initial or subsequent hanging of the blood. I would say this is a medication error. Wrong site. Should have alternative iv site to run the protonix if it absolutely couldn't wait til blood was in.

[MunoRN, 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.

I'm not sure what you mean, how would IV protonix, which is hypertonic, cause the blood to become hypotonic?

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?

Are you saying that no other fluids/drugs should be infusing during a transfusion, even in another IV?