Transfusion too fast?

[Butternut]

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.

[bigsyis]

One hour is not that fast. But in a non-critical symptomatic patient I usually take 2 to 4 hours, depending on their age and condition - young folks I tend to go faster than older folks.

On the floor I hung it as Tweety describes. Our hospital policy was that the unit had to come down after 4 hrs and an incident report had to be written about why the infusion wasn't complete in that length of time!

[micker14]

Does your unit have a policy in place for the Level One infuser? i need to come up with a policy for my unit and wanted to see what other hospitals have in place.

[brownbook]

The unit of packed red blood cells was approximately 250 - 300 cc's of fluid.

Giving any amount of fluid from normal saline to lactated ringer to D5 1/2, any IV fluid, giving 300 cc's in one hour is not necessarily dangerous? Of course a frail elderly or cardiac or renal, or, etc., etc., etc., various reasons a patient couldn't tolerate 300 cc's in one hour that would be taken into consideration. But outside of those considerations I see no problem with 300 cc's of any fluid in one hour?

I can't see that the patient needed to be in intensive care or on tele. She just needed one unit of blood.

[Anna Flaxis, BSN, RN]

I've run blood over 2-3 hours on a pump with blood tubing, wide open by gravity, and on the Level 1. It depends on the clinical situation. One unit over one hour isn't terribly fast, and the patient must not have had any comorbidities that would concern the doctor regarding rate of infusion.

[Argo]

normal day on the nursing unit, 2-3 hour infusion time. normal day in the OR probably 15-30 minutes with a ranger fluid warmer or hotline. when someone is actively bleeding and I am with them preop, I have given them in minutes using a hotline or level 1.

[carolmaccas66, BSN, RN]

I've given lots of blood over an hour or 30 minutes. I've never given it wide open, but I've heard of nurses doing this when someone is bleeding out.

[Horseshoe, BSN, RN]

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.

that's the most surprising thing about your whole post. giving blood over an hour has never been done in your icu?