Question about FFP

RN2B07 · Jul 27, 2006

Hi...I am very sorry to hear about your day, I would be freaking out as well. I have only given FFP once and our hospital policy states plasma may be administered rapidly (approximately 300 mL in 15 to 30 minutes)...so you were right in doing that. I had administered 4 units..and 1 unit per bag. Our bags will state on label that it is 1 unit. Whether that is universal or not I am not sure. Again I am sorry to hear about your experience but it sounds like you have done everything right...what did your charge nurse say after the pt. coded. I would think reports must have been done, did he/she reinforce your actions to be right??

Nurse1966 · Jul 27, 2006

It was a BAD Saturday. The code team had been real busy that morning, and had seven other patients for transfer to ICU, so the nursing supervisor didn't say much of anything. There's never really any follow up. Thankfully, our on call Resident was right there from the beginning. Thanks for your response!

RN2B07 · Jul 27, 2006

Yes risk of rxn is low...but did your pt. show any s/s of a rxn?? Any change in vitals?

NYNewGrad · Jul 27, 2006

We run FFPs pretty frequently on floor. And yes, blood bank will often combine 2-5 units of FFPs in one bag and we still run it over 15 - 30 minutes. Sometimes it says on the bag how many units and other times I would call them to clarify.

How else do you run 5-10 FFPs with 6 other pts?!

Nurse1966 · Jul 27, 2006

The pt was unstable when he came to the floor, his pressure was 80's/40's (which for him was good). He was endstage chirosis 2* Hep B & C. His urine output was nonexsistent, all his labs were abnormal, they couldn't even get a PT/INR to read, it was so high. He developed some wheezes/rhonchi, gave him Lasix, no output at all. The docs insisted he get the FFP even though he was definetely overloaded w/fluid. I don't know if dopamine or dobutamine would've had much effect with his liver so bad. It was one of those situations where there's no good outcome as is often the case with IVDA's when they come to the end of the road.

DarlinNurseRed · Jul 27, 2006

Gosh this patient and situation sounds exactly like my patient the other day-PRBCs, FFP, Lasix, boluses, no output and a doctor who talked to me like I was an idiot.

General E. Speaking, RN, RN · Aug 2, 2006

and a doctor who talked to me like I was an idiot.

don't you just hate that

gitterbug · Aug 8, 2006

Take VS prior to calling BB for FFP. You also need to have at least a 20g

med-lock site, that is patent and flushes well. Pick up FFP, check FFP per BB and floor protocol, hang FFP(our tubing is supplied by BB). If FFP is still running after 15 minutes, repeat VS. Our gtt rate is rapid unless ordered

differently by physician or patient has severe respiratory problems. I have never had a unit of FFP hang more than 30 minutes, but if it has not infused in 4 hours, it needs to be taken down, the physician called and and incident report filed. Of course, the patient needs to monitored more closely after the FFP is completed. Like VS 2 hours after completed, check for rash, monitor lungs and kidneys. This is the older way of administering FFP but no place I have ever worked taught me better than the first one were FFP

was given often.

Daytonite, BSN, RN · Aug 10, 2006

first, you did nothing wrong. this patient needed the plasma for the platelets and probably the protein as well. ffp has clotting factors (lots of platelets) and serum in it. sounds like your patient had one foot in the grave already. it was frequently used during the korean war in place of blood which was often unavailable. yes, they frequently combine several units of it together. you usually run it in as fast as possible. abo compatibility is not usually a big factor with plasma since all the rbcs are removed. the first link i've listed gives you a table of the various components of blood that are transfused. ffp is on the list. you might want to print it out and put it on a clipboard to carry around with you for future reference. the rest of the links include information about transfusions, transfusion reactions, or information about plasma. read up and now you'll have all your questions answered and be a mini-expert on this!

http://teach.lanecc.edu/nursingskills/blood/transfusionproducts.pdf - a table of the various transfusible blood products

http://www.muw.edu/nursing/iv.htm - the last half of this document has information about the procedure of blood transfusion and transfusion reactions

http://users.rcn.com/jkimball.ma.ultranet/biologypages/b/blood.html - here is a biological review on blood with a discussion about plasma and what is in it.

http://library.med.utah.edu/webpath/tutorial/bldbank/bbproc.html - a short explanation about plasma and packed cells

http://library.med.utah.edu/webpath/tutorial/bldbank/bbtxrxn.html - adverse reactions to blood products - transfusion reactions

RN2MSNasap · Sep 4, 2006

I have hung FFP many times....we treat it as any other blood product procedure wise with vitals...please know that you did not do anything wrong ..your pt was end stage, but I know its hard to have a critical pt and then have them code when you are trying your best, but things like this are out of our control...I myself have never had more than one unit come in a bag, my institution will only release one unit at a time to the floors which is frustrating when you have to give more than 2...and yes you infuse it in 15 to 30 minutes at least thats what I was always taught, and even though the risk of reaction is said to be low as with any other blood product it has to be monitored with vitals signs taken at a minimum of every 15 minutes and frequent patient assessment...hope that helps...good luck:nurse: