I'm just curious.. let's say a patient came in with a Hemoglobin/Hematocrit of 6 & 21. PRBC's 2 units were given. H&H re-checked an hour later, to be 8 & 23. Ordered to transfuse 1 more.
My question is, after the last unit of transfusion.... without checking H & H, someone mistakenly gave another unit for a total of 4 units that day instead of 3. Would it do a lot of harm to the patient?
This came up when a co-worker got really confused by the I&O's from the last shift; the intake for blood transfusion didn't quite match up. I left work early so I didn't find out what happened (whether or not the blood should have been given or not).
But can giving one unit of PRBC's with a H&H that low be really harmful?
Please answer, thanks. I'm about 6 months experience as an RN, and would really loooove to know.
Not necessarily. It wouldn't be a stretch that they typed and crossed several units when the patient was initially typed and crossed, especially if they had such a low HH. Often they set up more units of blood than are ordered. Often there are units of blood available and never used.
In the hospital where I work the lab can only set up as many units as the doctor orders, hence, when ordering another after a repeat H&H we often had to wait for the blood to be ready. I'm sure it's done differently in different hospitals. I was referring to my own situation. But I agree that it wouldn't necessarily be a stretch if the lab did things differently.
We had a patient one time who on the floor got an order for 3 units of blood on call to surgery. The floor nurse transfused all 3 units sent the patient to the OR and when the blood was needed there was none available and
I'm just curious.. let's say a patient came in with a Hemoglobin/Hematocrit of 6 & 21. PRBC's 2 units were given. H&H re-checked an hour later, to be 8 & 23. Ordered to transfuse 1 more.
My question is, after the last unit of transfusion.... without checking H & H, someone mistakenly gave another unit for a total of 4 units that day instead of 3. Would it do a lot of harm to the patient?
This came up when a co-worker got really confused by the I&O's from the last shift; the intake for blood transfusion didn't quite match up. I left work early so I didn't find out what happened (whether or not the blood should have been given or not).
But can giving one unit of PRBC's with a H&H that low be really harmful?
Please answer, thanks. I'm about 6 months experience as an RN, and would really loooove to know.
I do not think additional unit of PRBC will harm the patient.
DutchgirlRN, ASN, RN
3,932 Posts
In the hospital where I work the lab can only set up as many units as the doctor orders, hence, when ordering another after a repeat H&H we often had to wait for the blood to be ready. I'm sure it's done differently in different hospitals. I was referring to my own situation. But I agree that it wouldn't necessarily be a stretch if the lab did things differently.