Post Transfusion Labs

jayne109, RN · Aug 21, 2003

We wait 2 hours usually. It depends on the doc. Occasionally, if it is close to the 5 am draw, the doc will have an hhduring the transfusion. How weird is that?

mj

Jen2 · Aug 21, 2003

I am still in nursing school, but I work as a Phleb in a hospital. We wait one hour. Sometimes the nurses would get a little frustrated when I tell them that I cannot do the scheduled H&H because the patient is recieving a unit. I wasn't sure why we waited and didn't know what to tell the nurses when they asked my why. I asked my blood bank supervisor and she told me that all I needed to know was that it was protocall. Whatever~thats not what I was asking her, but anyway, I would like to know more about this also. It seems that in my hospital anyway, that it is the procedure of blood bank unless the physician over rides this. Why is it we can draw above an I.V. site after it's turned off for 5 minutes but have to wait an hour after a transfusion?

passing thru · Aug 21, 2003

I'm just guessing. Here's what I think. Frequently, we give the patient iv Lasix after the blood has infused.

Maybe that has an effect on the results.

Anyway, we generally wait an hour. Giving everything time to get "mixed up" real good, and decreasing the "dilutional" effect, in the event more than 100 or 200 mls of saline was also infused between units or after the unit was infused.

Sometimes a 500 ml bag of saline is hung - - or two 250 m. bags of saline. I've seen a whole bag of saline infused after the blood.The nurse gets busy and the whole bag of saline infuses while waiting to "clear the tubing" of blood. and also to give the Lasix time to do its' work.

I think the docs think the hour or two waiting period gives the patient time to diurese out all of the saline and any extra fluid retention the patient has, so then, the results will more accurately reflect an accurate H/H.

RN-PA, RN · Aug 21, 2003

The only set protocol for blood we have on our Med/Surg floor is to obtain a platelet count one hour after platelets have been transfused. No protocol for H&H after packed RBC's given. Depends on the doctor, but most seem to order labs for the a.m. the next day. I recently DID have an order to draw an H&H after a unit of packed RBC's had infused for an oncology patient, but it's been rare in my experience to draw them that soon afterwards.

renerian, BSN, RN · Aug 21, 2003

WE waited one hour.

renerian

Kayde · Aug 22, 2003

Ive had 2 same day 2 prbc infusions in the last week. One patient was sent home and bloodwork to be drawn 4 days later. The other patient had an H and H drawn right after the blood was flushed and was discharged after the doctor knew the results. We draw right after flushed.

grouchy · Aug 22, 2003

I was originally taught that the standard was 4 hours post-transfusion. Don't remember the rationale. Then, went to another area in the same hospital, where they usually do a f/u h/h 1-2 hours post transfusion. I'm thinking of posting a new thread. What is your protocol for vital signs during blood transfusions? Has anyone else heard that less monitoring is needed with leukocyte-reduced PRBC's? Also, what is your cutoff H/H, below which you will transfuse the pt? Has this been affected by the blood shortage?

duck_1978 · Aug 29, 2008

New RN here. This is probably a dumb question but I can't get a straight answer from several of my "senior" RN's. We frequently get an order to follow the 1st unit of blood with 20 of Lasix IV. How long after the unit finishes should the lasix be given? Should the line be free of blood before I push the Lasix? Can I hook it to the pump? Do I flush the line with saline before and after the lasix? Thanks.. :no:

blondy2061h, MSN, RN · Aug 29, 2008

We draw a post-platelet 15-30 minutes after platelets finish, and another CBC w/ AM labs, unless they're on q8h CBCs, which we get also. Sometimes they'll order otherwise, but rarely.

madwife2002, BSN, RN · Aug 29, 2008

The only set protocol for blood we have on our Med/Surg floor is to obtain a platelet count one hour after platelets have been transfused. No protocol for H&H after packed RBC's given. Depends on the doctor, but most seem to order labs for the a.m. the next day. I recently DID have an order to draw an H&H after a unit of packed RBC's had infused for an oncology patient, but it's been rare in my experience to draw them that soon afterwards.

Unless they are actively bleeding then we dont draw until the next day either

duck_1978 · Aug 29, 2008

We usually get an H&H 2 hours post transfusion unless the MD orders differently. My real question is about the Lasix post transfusion. Does the line have to be free of blood to push the Lasix? How long do you wait before pushing the Lasix? Thanks.