question about blood transfusion and medication

[EMTI19]

I am currently a first year nursing student and in my last class it was highly stressed that the only thing you could give with blood was NS. Yesterday I was working at the hospital as a CNA and heard an RN asking the other RN's about giving lasix through the blood tubing. The other RN's told her to just clamp the blood, flush the tubing with NS, push the lasix, flush the tubing again with NS, and continue the blood. I was just wondering if this is an acceptable practice?

I know that I have alot to learn and that will come with more classes and time, but I just didn't have a good "gut" feeling about this. Any input would be appreciated. Thanks!

[UM Review RN, ASN, RN]

In the tubing that we use, you would actually have to disconnect the tubing in order to flush it as there are no ports. So you're not really giving it with the blood or even in the same tubing.

And usually the lasix IV is given after the blood is completed.

[begalli]

Sounds like they just needed the line to give the lasix. Maybe it was the only access available? It's not like they mixed the lasix with the blood. Seems acceptable to me.

The thing I wonder about is why they're giving the lasix before the blood is finished - unless they were giving multiple units with doses of lasix in between?

[Nesher, BSN, RN]

You know sometimes rules are made to be broken... That said it sounds like perhaps the person didn't have any other kind of access and had to use the blood line as they did. I admit I have done such activites when I had a need.

Question - what does your hospitals policy and procedures say about this?

[TennRN2004]

I'm thinking the RN was probably hanging 2 units of PRBCs and the order was to give the Lasix in between units. That would make the most sense to me. I know we would have a new set of tubing for each unit also, so the Lasix wouldn't be pushed through the blood tubing in my hospital. From what you described though it sounds like safe practice. What they're telling to you in school is that blood is not compatible with anything but NS- for instance you wouldn't hang blood with D5 NS, or 1/2 NS you only hang with NS.

If you had blood going into the only line you had, and you needed to give IV pain meds or another scheduled IV med, you would do exactly what you described to push another med. Disconnect the blood, push NS to clear the line, push your IV med, push NS to clear the line, reconnect the blood. It's not idea, but if you only have one line to work with, sometimes that's how you have to do it.

[meownsmile, BSN, RN]

I agree, I wouldnt have a problem clearing the lock with saline and giving a push med then reconnecting the blood. I cant tell you off the top of my head if our blood sets have a port at the lower end, but i can say if i needed to i have no problem with clamping blood tubing and flushing to infuse Lasix or pain med IV if needed. Of course followed by a 10ml flush before i restart.

[EMTI19]

Thank you for all the help. I don't have any answers about exactly what she was doing (giving 2 units, only had one line, etc...) I feel better about the discussion that I overheard. Maybe that bad feeling in my gut was about something else at the time. I have been trying harder to be more in tune with that. I almost feel embarrased that I asked now without all of the necessary information. :imbar I guess that is what I get. Anyway, thanks for all the info and insight :)