Level 1

[nursequeenie]

Do you need to dilute PRBC's with NaCl prior to running through the level one? They just seem so thick....If you need to dilute how do you do it, assuming you have PRBC's on both sides of the level 1.

Thanks in advance.

[WWRN]

My understanding is you can just run them in "full strength". I'm interested in what others do...

[Altra, BSN, RN]

The whole point of using a Level 1 is to rapidly infuse fluids and/or blood. If you're using the Level 1, then by definition, you need to get whatever you're infusing in as soon as possible without dilution.

PRBCs are infused undiluted through regular peripheral IV tubing -- what would be the issue infusing through Level 1 tubing, which is nearly garden-hose diameter?

[meandragonbrett]

Why would you dilute PRBCs when you don't when not using a rapid infuser?

[ddoosier]

no we do not dilute PRBC when using the level one. As mentioned, the level one is used to rapidly deliver fluids/blood products during the resuc period. What is the rationale behind this question if you don't mind me asking? When administrating blood products, it is attached to another line of NS used for flushing purpose and a bolus if needed.

[Roy Fokker, BSN, RN]

Wait. Why would you want to dilute PRBCs anyway - Level 1 or otherwise?

cheers,

[likemike, BSN, RN]

Nope,

Good question. A lot of Nurses are afraid to ask a question.

The blood is viscous as it is cold, but just put it in the level one, which hopefully is heated, seal the door and pressurize the bag.

That is the reason for the level one, to rapidly infuse crystalloids or blood.

It works great.

[mmutk, BSN, RN, EMT-I]

We donot infuse PRBCs through our level 1 either.

[Christy1019, ASN, RN]

I'm sitting here at work in a level 1 trauma center in detroit, mi and since im a new grad i thought it might've just been something i didn't know, but none of the nurses here that i've asked know what you guys are talking about a "level one".. ?? are you talking about the rapid infuser?? we're sitting here waiting for an answer now that i've peaked everyone's curiosity lol.

[likemike, BSN, RN]

It is the brand name of a rapid infuser, it can warm up fluids to 42 degrees C, ours is labeled a level one, that must be the company name? It is used in all of our trauma rooms and in the OR. Hope that helps, oh yeah, if you unplug the tubing, you can rapidly infuse fluids, it makes a beeping noise as the fluids are at ambient temp. We used it on a tweaker who rather than be arrested, swallowed all of her meth, she had a core temp of 41 and was dry, 70s systolic so we just took off some of the tubing to give her 3 L IVF at room temp. Hope this makes sense

[Medic2RN, BSN, RN, EMT-P]

I'm new to the ER. A few shifts ago, we had to use the Level I and infuse some PRBCs and the nurse diluted it. I asked her why she was doing this and she said it was easier to displace the air pocket when hooking it up in the infuser.

I don't know if that's correct, but that is what I was told.