PRBC Administration during dialysis

[klm49]

The question keeps coming up in my hospital as to how fast we can give a unit of PRBC's during a dialysis tx. Traditionally we have infused 1 unit of PRBC's over 20-30 min into the Art chamber with continuous monitoring of temp and vs q 15 min. We also calculate the vol of the blood into the total UF goal. Dialysis is one of the only units in the hospital that blood bank will release 2-3 units of PRBC's at the same time to, simply because we can give the blood so quickly. Some of my newer staff have begun to challenge this and question the possibility of missing a transfusion reaction. Of course the hospital also wants evidence based practice. It is very difficult to find anything other then opinion on the internet so far. So what does your facility do? Any suggestions for reference sources?

[Tish88]

I give each unit over 30 minutes. During the first 5 minutes I will check their temps and bp's about 3 times, because if you are going to have a severe reaction it normally happens during that time period.

After that 5 minutes, I go to 15 minute checks and complete final vitals at the 30 minutes when the unit is done.

I tend to run the transfusion slower during those first 5 minutes and then when there is no sign/symptoms of transfusion reaction, I will speed up my rate.

I have done it that way for over 20 years.