Really dumb blood admin question

Is it possible you misread/misunderstood the way the policy was written? It would make more sense that it be "50ml/hour for the first 15 minutes" rather than "50ml for the first 15 minutes" (which would be 200ml/hour, as you said)

OMG Klone, I didn't think of that but no I don't think I misread but I was doing modules. I will have to check the written P&P this weekend. BUT 200ml/hr would be WAY too fast, right? That is what we were arguing as well....

I always do 75 ml/hr for the first 15 minutes but I don't think our policy gets that specific.

Yes, definitely think 200ml/hour is too fast. We wouldn't run that at the normal admin speed, let alone the initial admin, which needs to be slower.

I would definitely reread that. I usually start mine at 60 mL/hour for the first 15 minutes and then bump up to 120 mL/ hour if all is well.

Our policy says to give the first 50 ml over 15 minutes which is 200 ml/hr. I then bump the rate down to 125 or 150 so that one unit transfuses in about 2 hours. I'll give the blood over 4 hours if patient had fluid over load issues.

My two cents: that policy is ridiculous.

Our policy says to give the first 50 ml over 15 minutes which is 200 ml/hr.

What would be the rationale behind giving it FASTER in the first 15 minutes?

Ideally, you should NOT be infusing any more than 30 cc in that first 15 minute period. The first 15 minutes is the time frame when the most deadly consequences to the administration of a blood transfusion reaction occur. So, start slow, monitor well, and then stop immediately as needed. Intravascular hemolytic reactions can occur with as little as 30mls of blood, and the quicker they manifest "themselves" the more deadly the reaction will be. So, do NOT set your pump for anything more than 120cc/hr for the first 15 minutes.

Our policy says to give the first 50 ml over 15 minutes which is 200 ml/hr. I then bump the rate down to 125 or 150 so that one unit transfuses in about 2 hours. I'll give the blood over 4 hours if patient had fluid over load issues.

See!!!! I don't get it. Why would you run the first 15 mins FASTER? My colleague argued that this helps trigger reactions faster therefore you can stop the infusion if one occurs. I'm definitely rereading and getting with my educator on this one! Thank you

Curious1,

Your "other nurse" is just plain wrong.. and you were right, and you were even MORE conservative than needed, but still right on. Yes, education is in order.

I suspect whoever wrote or edited the policy screwed up the rate/volume terms. This will surely cause conflict between nurses who recognize the underlying issues and intent of the policy and nurses who have no idea.