Platelet Administration

[rn39648]

I have recently been made aware of a method of platelet administration that I am unfamiliar with. I have been asking around, but am not getting far. For our general adult population, our platelets come in a unit bag. We have recently discovered that our ICU nurses are giving platelets in a "push and pull" fashion, in which they use a Y-type set (one end spiked - for inserting into the bag and the other, a luer lock - for placing a large syringe) to pull the platelets from the bag into the syringe and push the platelets rapidly into the patient. Are there any concerns for platelet activation, contamination, and the like from using this method? I should also mention NS is not attached in any way, so in case a reaction, they could potentially be unprepared.

[iluvivt, BSN, RN]

I need to know is there a standard IV filter on the set that the platelets run through before they are pulled into the syringe? If no they are not following INS guidelines.

[KeepinitrealCCRN]

I've always only hung platelets with special tubing (a filter) and it is hung by gravity usually goes in within 30 min.

[iluvivt, BSN, RN]

If this Y type set up has a standard blood filter (can't be a micro aggregate filter) it can be done this way, '

[canoehead, BSN, RN]

I've done it this way. If they have a hub on the catheter, they can just disconnect and push a saline flush, for the same effect as a NS drip, in the event of a reaction.

[boomshakelaka]

over gravity it could take about 20 minutes. how fast is this push and pull method?

what i understood is that platelets cant be administered under pressure. the cells become unstable/break so the patient does not get the platelet increments they should. so pushing rapidly or using a pressure bag is probably not recommended.

[MunoRN, RN]

Studies on the effects of rapid infusion / pressurized infusion on platelet function and aggregation have found no adverse effects resulting from these methods. Physiologically speaking there's not much basis to believe that this would be an issue either.

[boomshakelaka]

On 4/14/2019 at 1:15 PM, MunoRN said:

Studies on the effects of rapid infusion / pressurized infusion on platelet function and aggregation have found no adverse effects resulting from these methods. Physiologically speaking there's not much basis to believe that this would be an issue either.

interesting. i need to find this article and bring it up at work as we do platelet transfusions quite regularly and this is the belief