Pressure infuser bag questions?

HeySis, BSN, RN · Mar 17, 2017

I have only used pressure bags on art lines... and then we are not really "infusing" more keeping the line open and the blood from getting pumped out and into the bag.

I would never "slam" blood products with a pressure bag. Blood products are kept cold, if you are giving a lot of them or quickly, use a rapid infuser, it warms the blood during infusing so that you don't lower a patients core temperature.

Is this an assignment for school?

Double-Helix, BSN, RN · Mar 17, 2017

1. Pressure bags are disposable because of infection control reasons, not because the effectiveness decreases after each use. You can use the same pressure bag for multiple fluid bags.

2. You're going to use as many pressure bags as you need to deliver the products/fluid that the patient needs to remain stable. But if your patient is so unstable that they need that many, pressure bags aren't going to cut it and you better be getting your hands on a rapid infuser asap.

3. Generally you don't re-inflate, though you're correct that the pressure drops as the fluid level decreases.

4. This will depend on the brand of bag and your facility policy.

5. Not sure what you're asking here. The rate achieved by 300mmHg vs 400mmHg will vary based on the product/fluid, the type and size of IV catheter and the type and size of IV tubing. The increased rate may or may not be clinical significant depending on how unstable the patient is and what's infusing. Again, if you need to be infusing that rapidly, you should be looking at options other than pressure bags.

Editorial Team / Admin · Mar 17, 2017

I would never "slam" blood products with a pressure bag. Blood products are kept cold, if you are giving a lot of them or quickly, use a rapid infuser, it warms the blood during infusing so that you don't lower a patients core temperature.

There are other options that quickly warm blood without needing to use the rapid infuser, such as the Level1 Hotline or the 3M Ranger.

HeySis, BSN, RN · Mar 17, 2017

There are other options that quickly warm blood without needing to use the rapid infuser, such as the Level1 Hotline or the 3M Ranger.

Good to know, I have never used/heard of either of those products. If we are giving multiple bags, quickly, we always break out the rapid infuser.... (maybe it's policy, or maybe it's conveniently located, i'll have to ask our unit educator about the others.)

MunoRN, RN · Mar 17, 2017

"Pressure bags" aren't really for infusing and I don't consider them all that useful for that purpose. A rapid transfuser, which is different from pressure bag, is for infusing fluids rapidly.

A pressure bag is used to create an constant elevated pressure on one side of a transducer in order for it to work properly. In a pinch, it can be used to rapidly infuse a large volume of fluid, but I don't find it all that useful since the pressure must be constantly replenished while the fluid is infusing, which makes no more convenient that just standing their applying hand-held pressure to the bag.

A rapid transfuser on the other hand is intended for rapidly infusing large fluid volumes and is far more practical and helpful.

medtechguy · Mar 17, 2017

thanks HeySis. I appreciate your time for the response. Hoping to follow up on a question based upon your response. Since your main use of pressure bags is for ART lines, and you need to maintain ~300 mmHg otherwise you can get an over-damped waveform, typically how long before the pressure bag drops below 300 mmHg. I think the pressure continues to drop but at a fairly slow rate if only infusing 3 mL/hour of fluid but not sure how sensitive the system is before you get overdampening. Is this something you need to address frequently by repressurizing the infuser bag back to 300 mmHg (once every few hours?, once per day?, etc) thanks again.

LovingLife123 · Mar 18, 2017

I mainly use them for art lines. I've used for blood once. It doesn't warm the blood in the least. It goes in quickly enough temp isn't affected. I used on a patient that was in need of it quickly but was only one unit needed. If they needed multiple units quickly, we have a mass transfusion protocol in place for that.

Im not sure what all you are talking about with over dampened waveforms and maintaining this 300 pressure. There's a line on the bag that shows up when you pump the bag up. You make sure the line is at the green. You don't worry about numbers. I assess the line at the beginning of my shift. If it needs pumped I pump it. I assess the waveform of the art line and I zero it. If it looks dampened and the pressure doesn't correlate with the cuff, I see what interventions I can do to fix it, or maybe the line is just bad. Art lines generally don't last that long.

argos · May 22, 2017

I have used them for years and never for an art line because art lines are mostly done in the ICU in the shops I've worked at. They are better in my experience than standing there and holding the bag. The pressure limit is 300 and it won't inflate higher because of a relief valve. It takes a minute to pump it up and then it will slowly lose pressure and you will need to pump it up about every 3-5 min. I use them 1 per patient not one per bolus. A level one infuser is best but not every shop has one so use it if needed but attach it to a fluid warm if you are using it for blood.

SouthpawRN · May 22, 2017

When I was a medic, we used bilateral 14ga IV's and a pressure infuser (or BP cuff) in a pinch and just pumped it up. didn't care what the pressure was. In fact the pressure infusers that went over the IV bags did not even have gauges... The good ol' days.

FineAgain · May 22, 2017

We don't use pressure bags for blood products either...mainly art lines as others have said. We use the rapid infusers for MTP. Pressure bags are great for dehydration or DKA...I don't pay much attention to the gauge just look to make sure it's running fast.