Lasix post transfusion.

[IngyRN]

Post PRBC, you run the NS to flush the line-how clear is the line prior to pushing lasix thru the port. My preceptor states that as long as the line is "pink". However, arent you still techically mixing the blood w/ med or is this reasonable??

[locolorenzo22, BSN, RN]

well, personally, I had this just the other week, as I had to push lasix after 4 units of FFP....I felt more comfortable flushing the line with a flush, clearing it, and then pushing then med, then flushing again....this way you can be sure that it went in. You should be flushing before pushing a med in any case...in my opinion.

[nrsang97, BSN, RN]

well, personally, I had this just the other week, as I had to push lasix after 4 units of FFP....I felt more comfortable flushing the line with a flush, clearing it, and then pushing then med, then flushing again....this way you can be sure that it went in. You should be flushing before pushing a med in any case...in my opinion.

That is the same thing that I do.

[IngyRN]

Sorry if I wasnt clear. The Y-connected NS had not completely cleared the blood, hence the line was still "pink"-would you still push thru this running IV even if it wasnt completely clear. I didnt push the lasix directly because she was getting a 2nd unit and preceptor said it was a waste of time to disconnect just to reconnect.

[psalm, RN]

Sorry if I wasnt clear. The Y-connected NS had not completely cleared the blood, hence the line was still "pink"-would you still push thru this running IV even if it wasnt completely clear. I didnt push the lasix directly because she was getting a 2nd unit and preceptor said it was a waste of time to disconnect just to reconnect.

I disagree with your instructor, about waste of time, I wouldn't use it with a running IV, I would pause the IVF, flush before lasix, give lasix, then flush again. If you flush enuff NS it should be okay. And sometimes I will use a new Blood Set tubing for the 2nd unit, sometimes if the blood is very cold it can coat the tubing too much between units.

Wherever you do clinicals, be sure to know what their protocol is for giving lasix between units of PRBC.

[koala_bear]

Hmm.. the protocol at the hospital I work at for blood transfusions is to use new blood tubing set per unit . In situations where we have to push Lasix, we'd disconnect patient from the tubing, flush with NSS, push Lasix then flush again. Grab another set of vitals, then go pick up the next unit of blood that needs to go in.

[iluvivt, BSN, RN]

The American Association of Blood Banks and the Infusion Nurses Society Standards recommend that blood tubing be used once and no longer than 4 hours. Also if you had a t-Extension or y-site (right at the site as in the intima PIV catheter) you could give it right there. Just flush with the NS as others have said then give the lasix and follow with the NS flush. Your thinking is correct though...no medications should ever be given in a blood line.

[psalm, RN]

The American Association of Blood Banks and the Infusion Nurses Society Standards recommend that blood tubing be used once and no longer than 4 hours. Also if you had a t-Extension or y-site (right at the site as in the intima PIV catheter) you could give it right there. Just flush with the NS as others have said then give the lasix and follow with the NS flush. Your thinking is correct though...no medications should ever be given in a blood line.

I agree...however, we are told we can use it up to two units. I think I will go with the 4 hour recommendation, as it makes more sense to me...for infection control and just plain sense. (So much for protocol, lol).

[crawlyberry]

Can you tell me why we are pushing lasix after a unit....still learning here.

[Kymmi]

Pushing lasix after a unit of PRBC's is to avoid fluid overload.

[crawlyberry]

Thanks...that makes sense.