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 Am I that out of date?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.

[Dplear]

We give blood all the time through 24 and 22 g caths. I work peds but some of the kids are big enough to be adults....we occasionally get sicklers on our w=unit. Think of it this way...when you draw blood it does not damage the cells and that is generally through a 25 g butterfly.

Dave

[Shae]

We are required to use #20 or #18 guage at our facility as well. We recently switched over to the newer BD IV caths which are more flexible, but no change in policy on administering blood products.

Shae

[Lynda005]

" a 24 gauge can deliver 1400 cc/hr" Wow, this may be true, but will the vein hold out? not for long, I think.

PRBC's can be given through a #22 at our facility, sometimes this is all you can get. Great Topic:)

[RNPD]

I doubt that any peripheral veins could take that much volume long term, but delivering 1400cc/hr would only be done at a crisis situation and once stabilized, the IVF rate would be regulated down drasticly. But the point was that the newer small gauge catheters have larger bores. Being capable of that high a volume, doesn't necessarily mean it would be used that frequently if at all. But don't forget that often during codes we run a liter bag "wide open" and that certainly would infuse in less than an hour. (so long as the vein holds out, of course!)

[MrsK1223]

We have to use 18 G and if we absolutely can't get an 18 in then we have to get a doc's orders to use a 20G...never heard of anything less..but we don't do babies or children.

[jadednurse]

I am the only one who gets frustrated about having to "get a doctor's order" for really obvious things like administering blood through a 22g vs a 20g if that's the only access the patient has? As if the doctor's going to refuse and say "well, even though Mr. Smith's hgb is only 8, policy is policy!"

[Teshiee]

It can be done. You would have to run the blood at a slower rate and divide the blood. In NICU we run blood through a 24 guage remember we have capillaries that are smaller and yet blood gets through......

[healingtouchRN]

I went to an all day IV certification (for advanced practice) & the instructor said ok to give blood through 22 or 24, that is how we with babies! They do just fine. Hard to change what has been engrained into our practice so long. But I am all for change when I don't have to gouge some sickle cell patient.

[Liann]

I am all for nurses using whatever access is available. However, I just want to reinforce that the blood must be split into smaller bags to hang for the longer time needed. Four hours is the longest a single unit can hang. Bacteria grow so rapidly....and blood is such a fine medium for them to feed on!

[mother/babyRN, RN]

Often depends upon the brand used. With autoguards, winged or otherwise, a 20 g is actually the same size as an old 18....Blood will run through a 20 certainly if it is an autoguard especially, however many docs are stuck in the present and stuck with the numbers. When anesthesia or some OB doc throws a nutty because they notice one of our patients has a 20 g ( and we use 18s despite the fact that the newer ones we use are autoguards), I have no problem letting them know that the pt is a difficult iv stick, has been stuck more than twice OR knows her veins well enough to know she will have a problem..It will always be about pt comfort and safety for me over anesthesia/OB desires in the odd cases when an 18 can't get in. That doesn't often happen in OB, thank goodness...I don't lose sleep over it...Other night three of us tried a blood draw and I finally was able to do it with a butterfly and a syringe because no blood would go into the tube via a vacutaner...Doc upset until I offerred to have her do it, and start the iv...I can only get an iv if the vein is obvious...Well, said I, it isn't so step up or step out...Never bothered me again after that....

[celestlyn]

On our floor, we 20 gauge is the smallest we use for blood. There might be an occassion we will try it through a 22 if the patient is extremely difficult to place and has no other unused sites.

[teeituptom, BSN, RN]

Personally I prefer 14g and 16 g and 18 g. But that comes from being in ER. If I cant infuse it 5 minutes then let it be done on the floor.

Love the Level 1 infuser