Transfusing blood

jottRN · Sep 23, 2011

I've also been taught both ways by different preceptors. I haven't checked to see if my facility has a policy on it, but I prefer to prime with blood for the same reason you gave. If you're documenting vitals on the transfusion of normal saline and then leaving just when the blood reaches the patient--the whole first 15 minute observation is kind of pointless.

ChristineN, BSN, RN · Sep 23, 2011

I've seen it done both ways. I've also worked places where no NS is used as a flush.

LovingNurse, BSN, RN · Sep 27, 2011

If priming with NS, I don't start timing the transfusion until the blood product has reached the patient. :redbeathe

dfs1961 · Sep 28, 2011

Prime with NS first. Clamp off.

Open blood clamp and squeeze it through the chamber.

Open up entire line over the sink (or a cup), and flush till the blood is at the tip of the port.

Hook up to the patient.

Start your blood very slowly, 20cc/hr.

Stay with pt for 15 minutes checking for transfusion reactions.

Take and record vitals after 1st 15 minutes.

Before leaving the room, up the rate to 100cc/hr (or however long you need to run it in over v. amount in the bag).

I don't like priming with the blood. For some reason, I like the tubing nice and clean with the NS first, which may flush out any bacteria or dirt in the line, and then let my blood run through.

IVRUS, BSN, RN · Sep 29, 2011

Prime with NS first. Clamp off.
Open blood clamp and squeeze it through the chamber.
Open up entire line over the sink (or a cup), and flush till the blood is at the tip of the port.
Hook up to the patient.
Start your blood very slowly, 20cc/hr.
Stay with pt for 15 minutes checking for transfusion reactions.
Take and record vitals after 1st 15 minutes.
Before leaving the room, up the rate to 100cc/hr (or however long you need to run it in over v. amount in the bag).
I don't like priming with the blood. For some reason, I like the tubing nice and clean with the NS first, which may flush out any bacteria or dirt in the line, and then let my blood run through.

Bacteria? Dirt in the line?? Wow, If I even QUESTIONED the integrity of the IV tubing, or had a hint that there may have been a compromise of the system, I WOULDN'T use it.... If I removed the IV tubing from its package and the caps weren't on both ends.. I wouldn't use it as the caps are the only thing keeping the sterile pathway of the tubing sterile!

dfs1961 · Oct 4, 2011

Bacteria? Dirt in the line?? Wow, If I even QUESTIONED the integrity of the IV tubing, or had a hint that there may have been a compromise of the system, I WOULDN'T use it.... If I removed the IV tubing from its package and the caps weren't on both ends.. I wouldn't use it as the caps are the only thing keeping the sterile pathway of the tubing sterile!

Uh, wow, I wouldn't use compromised tubing either. No one said using tubing that was compromised.

I<3H2O, BSN, RN · Oct 4, 2011

Uh, wow, I wouldn't use compromised tubing either. No one said using tubing that was compromised.

Actually, by saying that you would use the NS to flush out any dirt or bacteria kind of indicates that you would...

I<3H2O, BSN, RN · Oct 4, 2011

I prime with NS first, I was taught in school that you have to prime with NS first as the blood could actually stick to the inside of the tubing. Now, I question that (LOL) however I still prime with NS first.

I prime with NS and then clamp. Spike the blood bag and open it up over a sink or cup or something and then hook it up to the pt. and begin my 15 minutes.

dfs1961 · Oct 5, 2011

Actually by saying that you would use the NS to flush out any dirt or bacteria kind of indicates that you would...[/quote']
Um, nope, wouldn't do that. And what I wrote indicates nothing of the sort. What makes you so confident that the tubing you just opened from a sterile package, with both ends attached and closed, is 100% sterile? Of course the company says it is, but they make mistakes as well and you just never know. I like to take the extra step in ensuring my patient's safety and the cleanliness of my tubing by 1st flushing with NS. Can't hurt, can only help.

cherrybreeze, ADN, RN · Oct 5, 2011

Uh, wow, I wouldn't use compromised tubing either. No one said using tubing that was compromised.

Um, nope, wouldn't do that. And what I wrote indicates nothing of the sort. What makes you so confident that the tubing you just opened from a sterile package, with both ends attached and closed, is 100% sterile? Of course the company says it is, but they make mistakes as well and you just never know. I like to take the extra step in ensuring my patient's safety and the cleanliness of my tubing by 1st flushing with NS. Can't hurt, can only help.

I'm sorry, your initial post and subsequent responses really show a lack of knowledge.

IF there were bacteria in the line (despite opening a sterile package and maintaining those conditions)...flushing the line with NS wouldn't get rid of it, first of all. Secondly, if it is sterile...it is sterile. I don't know what type of tubing or packaging you are using that would make you "question" that, but ... wow. Just wow.

If you think there is "dirt or bacteria" in the line, then yes, it IS compromised, and you seem to think that normal saline is enough to "fix" that problem. Really?

allnurses Guide · Oct 6, 2011

Ok guys, can I ask that you refrain from personal comments, please debate the topic and not individuals