Transfusion too fast?

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Specializes in Big Variety.

What is the quickest you have run in a unit of packed RBCs? The doctor ordered a unit to be given over an hour's time. This scared me. I called Critical Care and they said they didn't remember giving any that fast and if they had, it had been many years ago. I ran it at 200 cc/hr and stayed with the pt for over thirty minutes. Lungs remained clear. BP improved. So actually it ran in in an hour and forty minutes.

She had been seeping slowly from a previous above knee amputation incision/infection/open areas. He is taking her back to surgery "tonight or tomorrow". The stump looked discolored to me and she has MRSA in it. Diabetic.

Thanks for your input.

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This week I gave three units within a total of five hours to an otherwise healthy young woman who bled out after childbirth. I'd never ran it so fast, either, but I used to work on a medical floor with people with several co-morbidities who just couldn't tolerate that fast of an infusion. It's strange to work with people who are mostly healthy. It doesn't sound like that's the case with your pt, though. I'm a newer RN, so I'm not sure what the norm is.

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Specializes in L&D, High Risk OB, OR, Med-Surg, PHN.

]:eek: I have hosed it in before wide open c fluids going wide open also for a fresh delivery that had a post partum bleed. B/P 80/30-40's. MD at my side and were getting ready to go back for a D&C. Did T&S and stat HGB and that was 6.0 p D&C and 4 units HGB came back up to 9.0. Pt tolerated this but normally new mom's are healthy to begin c just pregnant.

Lisa

:cool:

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Specializes in ED.

I normally try to give blood over 3 hours on the med-surg unit, so I have time to play with for the 4 hour total window, like just incase their peripheral IV goes bad or something. During a trauma if needed we can transfuse blood within 1-5 minutes with the trauma tubing, but I'm new down there and havn't had to do that yet.

Really it all depends on what is going on with them. If they are a renal pt or chf and wet on the lungs, I would be careful.

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I've dumped it in over minutes with a pressure bag when necessary.

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Sometimes you've gotta do what you've gotta do... time wise.

Missy

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With a patient bleeding out, and having good central line access like a cordis, as fast as I can with a pressure bag on it.

On a med-surg floor, I like giving over 3-4 hours. Blood tubing that can go on a pump has made things much easier that way.

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Specializes in ER, ICU, L&D, OR.

Try using a level 1 rapid infuser, pushing units over just a few minutes each

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Specializes in ITU/Emergency.
Try using a level 1 rapid infuser, pushing units over just a few minutes each

Yep, with those messy GI bleeds or with trauma, it can go in as quickly as it comes out. If you are the nurse looking after the level 1 infuser, you can literally stand there and hang blood every few minutes and the rapid infuser infuses 2 units at the same time.

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Specializes in ER, Occupational Health, Cardiology.
I've dumped it in over minutes with a pressure bag when necessary.

Exactly-sometimes two units going into two separate lines simultaneously using the pressure bags in a trauma.

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Specializes in Emergency.

Why did the MD want to infuse it so quickly?

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I've done it more than once, with a pressure bag and using central line.

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