Transfusion ?

PJMommy · Oct 8, 2003

According to my Med Surg book:

First fifteen minutes - infuse no faster than 2 mL/min. Then, "After the first fifteen minutes, the rate of infusion is governed by the clinical condition of the patient and the product being infused. Most patients not in danger of fluid overload can tolerate the infusion of 1 unit of PRBC over 2 hours. The tranfusion should not take more than 4 hours to administer."

You also have to stay with the patient for the first 50 mL.

RNKPCE · Oct 8, 2003

We stay with the patient the first 5 minutes of the blood transfusion, inform them to notify us of any changes in how they feel. We check vitals 15 minutes after the start of the tranfusion. The rate of the overall infusion is ordered by the MD. We have a lot of CHF patients and usually infuse over 3-4 hours.

jnette, ASN, EMT-I · Oct 8, 2003

hmmmmmmm... and MY medsurge book says (1st 15 min.) infuse no faster than 5 ml/hr. Interesting. Why such a difference? Also to stay with patient 1st 15 min.

patti101 · Oct 8, 2003

THANK U !!!!

BarbPick · Oct 8, 2003

OK, Old lady here .

You are looking for a transfusion reaction, that is why you are in there most of the first 15 minutes. Strange thing about transfusion reactions, the happen almost imediately, it should be in the first 5 minutes anyway. You infuse it at a nice slow steady pace. The first thing that will happen, you will hear a Giant Gasp, like a major wheeze, and hopefully the patient has a foley cuz you need to see what their urine looks like. If the urine is pink to red, bingo, it is an official transfusion reaction.

They will be red in the face and blochy all over.

You must shut the blood off, and disconest the blood tubing and start a slaine drip. Why not run the saling that is piggybacking the blood, cuz there is still blood in the tubing. No don't say, we know that, duh, well Duh, it will be on every major exam you take in your life. This is where 3 3 10cc syringes of saline come in handy, as you are screaming for someone to get an IV of saling started while you stay with the patient, You can flush the saline lock, or what ever you call the heparin lock gizmo in your institution, you can keep it open with the saline flushes, and follow the protocol in your hospital, some push benadryl, it doesn't matter, you can keep the lock open and ready for any emergency order you are given. BTW, transfusion reactions are extremely Rare.

Ok Boys and girls, why do we no longer transfuse whole Blood?

I will check back

jnette, ASN, EMT-I · Oct 8, 2003

Originally posted by BarbPick
Ok Boys and girls, why do we no longer transfuse whole Blood?
I will check back

To prevent fluid overload? Whole blood to be used only if significant blood loss (>25%). Am I right?

PJMommy · Oct 9, 2003

Aren't there more antigens in whole blood - placing patient at higher risk for transfusion reaction?

kellye · Oct 9, 2003

My vote is with PJ.

PSA, RN · Oct 9, 2003

Mine too...

CarVsTree · Oct 9, 2003

Whenever possible, the transfusion consists of only the blood component that meets the patient's specific need, rather than whole blood. Giving a specific component is both safer and less wasteful.

Google

gwenith, BSN, RN · Oct 9, 2003

Okay now I have one - question that is:)

Do any of you "flush" the tubing between blood bags with saline and do you flush the line afterwards before disconnecting?