Running blood through a #22 or #24???

[catrn10]

I am in orientation as a traveler at an urban hospital and they have just told me they run blood through #22's and #24's. Ok, I know I'm getting old, but when did that start? I was always taught that it would lyse if you used one that small. I'm very uncomfortable with it. Are there new studies that say it's ok? Am I that out of date? Any input would be appreciated.

[plumrn, BSN, RN]

I'm thinking it's hooey... (smile)

Brings up another question. When I was a new nurse, we never used pumps to infuse, because it 'lysed the cells'.

Now, we use pumps all the time. Was told by the pump representative that it was not a problem using the pump to infuse blood.

Any comments?

[deespoohbear]

I think I remembering seeing an article in either Nursing or RN a few years ago about the 18-20 g catheters not necessarily being necessary for transfusions. I have given blood through a #22 before with no problem. Sometimes you just have to go with what God gives you....

I always use a pump for blood. Most of my patients are elderly and can't handle the excess fluid volume very quickly. Usually give Lasix IV between the units too...I just feel a little better using the pump.

[mark_LD_RN]

yes blood can be given through the new thin wall 24 ga caths, but it has to be given slowly. I still try to get larger ones in just in case:)

[catrn10]

Thank you, just what I needed. I feel better now. I'm getting those articles for back home..Cat

[KRVRN, BSN, RN]

Speaking from the NICU again... We usually give blood over 3-4 hours but will give blood IVP through a 24 guage if things are really going downhill. Never have problems even if it's IVP. In fact we don't even stock anything bigger than 24 guages because we just can't get anything bigger on preemies. I've even drawn blood with a 25 guage butterfly. Never had problems.

[NicuGal, MSN, RN]

We use only 24's and 26's in our unit and our UVC's are 5 fr. Wonder if adults need a bigger one so it can run faster, but I have pushed 60cc of blood thru the above with no adverse reactions.

[caroladybelle, BSN, RN]

Research has shown that it is safe to give blood through a #22, but most hospitals have not updated their policies. Right up there with using just alcohol w/o betadine for site prep.

However, if giving a lot of blood and fast (for trauma) a larger needle is still preferable.

[RN-PA, RN]

Research has shown that it is safe to give blood through a #22, but most hospitals have not updated their policies.

Then our hospital is outdated, because #22g is allowed. Many patients don't have the veins for anything larger and would have to have central lines placed before receiving blood.

[askater11]

I'm at a new facility it sounds like they're very strict about 20 ga or higher.

But at my old facility 22 g was fine. There were times we were lucky to get a 22 g in let alone a 20 g and there blood counts went up well. (I've never used 22 g for platelets or plasma so I don't know if there's a difference)

[ceecel.dee, MSN, RN]

:) Great topic. Time to spif up the old policy!

[gwenith, BSN, RN]

I was told that the old myth about not giving blood through a pump had been debunked on the basis that if a red cell can get through a caapillary then a pump of a small IV catheter was not going to affect it. Having said that the older the blood is the more fragile the cells and increased turbulence and pressure can cause haemolysis. Yes the larger IV's for rapid infusion (I work ICU if we could use a garden hose we would).

[Sleepyeyes]

We use 22's all the time; no pump for PRBCs.