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

cab631 · May 25, 2003

I've used 22's when I can't get anything else--doesn't seem to cause a problem. Most other nurses don't like it cuz of all the "hooey" out there, but it works just fine.

2rntish · Jun 6, 2003

It is not a size thing but a pressure thing. The filter on most blood tubing is between 170-210 microns (much smaller than a 24 gauge). Blood cells fit through that without damage, the capillaries in your finger tip or smaller still.....

The issue is when you go from something the size of blood tubing down to a 24 gauge cannula, the pressure is what damages the cell. If the blood will flow to gravity you are OK. You may have to dilute with NSS in some cases. Most pumps are set at a pressure limit that, if it does not alarm, you are OK to pump blood. I agree with the idea BIGGER is better when pumping blood or fluid resuscitation but sometimes we take what we can get.

And please don't restick the little old lady with a good 22 gauge unless absolutely necessary.

renerian, BSN, RN · Jun 6, 2003

Still a debate eh? LOL.

renerian

Teshiee · Jun 9, 2003

we use those small guage without any problems.We normally set it on a med infusion pump.

Wendy Psych RN · Jun 11, 2003

I graduated last year and nothing was ever said about running blood thru that small of a catheter. The blood cells would lyse if squeezed thru that small of a lumen.

**canoehead, BSN, RN** · Jun 11, 2003

Blood cells are invisible to the naked eye...the width of any catheter lumen is not...therefore the blood cells could go down the catheter in a Rockette line and still get through without damage. You just gotta keep the rate under about 250cc/h, and I think we can all manage to do that.

sandyth · Sep 4, 2003

We always use an 18 or 20 , nothing smaller.

caroladybelle, BSN, RN · Sep 4, 2003

Originally posted by Wendy Psych RN
I graduated last year and nothing was ever said about running blood thru that small of a catheter. The blood cells would lyse if squeezed thru that small of a lumen.

Studies have been done regarding that matter and have found that there is little to no lysing unless the blood is being giving very fast/under excessive force.

casper1 · Sep 4, 2003

I work in oncology, hemotology, I have successfully transfused may patients with 22s. A 20 guage is ideal but often the patients veins are in such poor condition a 20 isn't possible. A 22 gets the job done. It requires close monitoring, but blood can be infused

in 4 hours or less.

purplemania, BSN, RN · Sep 4, 2003

Check with Am. Red Cross, but I believe they have stated it is ok to use 22 g., which I have done on elderly or any hard stick. ER and OR probably need faster infusion, however. Also depends on volume---4 pints would probably be stretching it. Have done 24 g with Bard pump (med infusion pump) for infants. Lysing is not as much a problem with fluids continually being infused.

Teshiee · Sep 4, 2003

In NICU that is not uncommon. Just run it at a slow rate but it will flow.

**canoehead, BSN, RN** · Sep 4, 2003

OMG I can't believe this debate is still going on!

Blood cells will not lyse through a 24, or even smaller. They get through the snout of a mosquitoe, which is smaller than a hair. The problem comes when you go at a fast rate and the pressure required to get that amount of blood through a small opening will damage the cells. However if you just run it slowly there is no problem. Soemthing to do with Boyle's law, that connects pressure, diameter, and rate.