Running blood through a #22 or #24??? - page 4

I am in orientation as a traveler at an urban hospital and they have just told me they run blood through #22's and #24's. Ok, I know I'm getting old, but when did that start? I was always taught that... Read More

  1. by   RNPD
    I doubt that any peripheral veins could take that much volume long term, but delivering 1400cc/hr would only be done at a crisis situation and once stabilized, the IVF rate would be regulated down drasticly. But the point was that the newer small gauge catheters have larger bores. Being capable of that high a volume, doesn't necessarily mean it would be used that frequently if at all. But don't forget that often during codes we run a liter bag "wide open" and that certainly would infuse in less than an hour. (so long as the vein holds out, of course!)
  2. by   MrsK1223
    We have to use 18 G and if we absolutely can't get an 18 in then we have to get a doc's orders to use a 20G...never heard of anything less..but we don't do babies or children.
  3. by   jadednurse
    I am the only one who gets frustrated about having to "get a doctor's order" for really obvious things like administering blood through a 22g vs a 20g if that's the only access the patient has? As if the doctor's going to refuse and say "well, even though Mr. Smith's hgb is only 8, policy is policy!"
  4. by   Teshiee
    It can be done. You would have to run the blood at a slower rate and divide the blood. In NICU we run blood through a 24 guage remember we have capillaries that are smaller and yet blood gets through......
  5. by   healingtouchRN
    I went to an all day IV certification (for advanced practice) & the instructor said ok to give blood through 22 or 24, that is how we with babies! They do just fine. Hard to change what has been engrained into our practice so long. But I am all for change when I don't have to gouge some sickle cell patient.
  6. by   Liann
    I am all for nurses using whatever access is available. However, I just want to reinforce that the blood must be split into smaller bags to hang for the longer time needed. Four hours is the longest a single unit can hang. Bacteria grow so rapidly....and blood is such a fine medium for them to feed on!
  7. by   mother/babyRN
    Often depends upon the brand used. With autoguards, winged or otherwise, a 20 g is actually the same size as an old 18....Blood will run through a 20 certainly if it is an autoguard especially, however many docs are stuck in the present and stuck with the numbers. When anesthesia or some OB doc throws a nutty because they notice one of our patients has a 20 g ( and we use 18s despite the fact that the newer ones we use are autoguards), I have no problem letting them know that the pt is a difficult iv stick, has been stuck more than twice OR knows her veins well enough to know she will have a problem..It will always be about pt comfort and safety for me over anesthesia/OB desires in the odd cases when an 18 can't get in. That doesn't often happen in OB, thank goodness...I don't lose sleep over it...Other night three of us tried a blood draw and I finally was able to do it with a butterfly and a syringe because no blood would go into the tube via a vacutaner...Doc upset until I offerred to have her do it, and start the iv...I can only get an iv if the vein is obvious...Well, said I, it isn't so step up or step out...Never bothered me again after that....
  8. by   celestlyn
    On our floor, we 20 gauge is the smallest we use for blood. There might be an occassion we will try it through a 22 if the patient is extremely difficult to place and has no other unused sites.
  9. by   teeituptom
    Personally I prefer 14g and 16 g and 18 g. But that comes from being in ER. If I cant infuse it 5 minutes then let it be done on the floor.
    Love the Level 1 infuser
  10. by   cab631
    I've used 22's when I can't get anything else--doesn't seem to cause a problem. Most other nurses don't like it cuz of all the "hooey" out there, but it works just fine.
  11. by   2rntish
    It is not a size thing but a pressure thing. The filter on most blood tubing is between 170-210 microns (much smaller than a 24 gauge). Blood cells fit through that without damage, the capillaries in your finger tip or smaller still.....
    The issue is when you go from something the size of blood tubing down to a 24 gauge cannula, the pressure is what damages the cell. If the blood will flow to gravity you are OK. You may have to dilute with NSS in some cases. Most pumps are set at a pressure limit that, if it does not alarm, you are OK to pump blood. I agree with the idea BIGGER is better when pumping blood or fluid resuscitation but sometimes we take what we can get.

    And please don't restick the little old lady with a good 22 gauge unless absolutely necessary.
  12. by   renerian
    Still a debate eh? LOL.

  13. by   Teshiee
    we use those small guage without any problems.We normally set it on a med infusion pump.