Transfusing blood

MaryAnn_RN · Sep 22, 2011

Our transfusion practitioner advises not to prime the line with normal saline. Her argument was that the saline isn't prescribed therefore should not be used. Nothing about vitals though.

xstarsfallingx · Sep 22, 2011

If you prime with saline, you need to wait until the blood hits the patient to begin your vitals...otherwise you are not accurately monitoring. I have always primed the blood down to the bottom so that it hits the patient when I begin the infusion. Then I begin my assessments. They are not going to have a transfusion reaction to NS.

CrazyCatLadyRN, BSN, RN · Sep 25, 2011

I was taught prime with NS then clamp that. Then open the blood tubing and let it run until it gets to the end of the tube then clamp again. Attach to pt and turn on. Why would you have to wait for 15 mins if the blood is right there at the end of the tube? It takes too long to just prime with blood anyway, it needs the NS to get it going through the tube. We do pre blood vs, after 15 mins, then every hour till it's done at my hospital.

CrazyCatLadyRN, BSN, RN · Sep 25, 2011

oh and we stay with the pt for the full first 15 minutes. Great time to do some charting

Guest296136 · Sep 25, 2011

I prime with NSS start it running at 50cc/hr then I send someone to get the blood from the lab, this way if there is a problem with the line or the IV access site I am prepared before I start the blood. I don't start counting the 15 min until the blood hits the vein.

Penelope_Pitstop, BSN, RN · Sep 25, 2011

I was taught prime with NS then clamp that. Then open the blood tubing and let it run until it gets to the end of the tube then clamp again. Attach to pt and turn on. Why would you have to wait for 15 mins if the blood is right there at the end of the tube? It takes too long to just prime with blood anyway, it needs the NS to get it going through the tube. We do pre blood vs, after 15 mins, then every hour till it's done at my hospital.

This is exactly what I do. Why? Well, if there's something wrong with that tubing it's best to learn BEFORE the blood is spiked. I prime the tubing with saline before the blood arrives so I can get a new set of tubing beforehand if needed.

classicdame, MSN, EdD · Sep 26, 2011

I agree with Mercy65. Hate to have the blood ready for infusion but the IV site is not patent. Important to start VS when blood acutually is being infused.

turnforthenurse, MSN, NP · Sep 29, 2011

Yes it is true that for the first 15 minutes you aren't getting accurate vitals because the blood has not hit the patient yet. I was taught to prime with NS first, clamp off the NS, then prime with the blood, put it on the pump and then connect it to the patient. Stay with the patient for the first 15 minutes to monitor for any reactions.

At my hospital, we do a set of pre-transfusion vital signs, then another set 15 minutes after beginning the transfusion, then every hour afterwards until the blood is done. The blood has to be hung within 30 minutes after receiving it from the blood bank and it needs to go in within 4 hours.

whitecat5000 · Oct 3, 2011

We were taught to prime with NS because they said "blood can clot in the filter if not primed with NS."

IDK if that's "evidenced based" though.

TonyaM73, ASN, RN · Oct 5, 2011

I always prime with NS first and clamp, then run the blood though to almost the end. If it gets all the way to the end before you connect to the pt, you have a huge mess. I agree with the above posts. Once the blood hits the pt, then count 15 minutes while in the room. Great time to get some charting caught up! Often, I am in the room for 20 minutes or so, because I get so engrossed with the charting. :)