Young & Ignorant

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Specializes in ER, Research.

When I was a young nurse, the floor RNs told me I could hang platelets on regular IV tubing. I did so after going to a new dept. later on & the guy ended up w/ chills & a fever. He was going for hip surgery after a fx. I gave him Tylenol & he was fine, but I think his surgery got delayed b/c of high INR. Anyway, I discarded the tubing/platelets after stopping the infusion and sent the blood sheet to blood bank. I read online later that night that ALL blood products should go on blood tubing to capture large leukocytes. I freaked out. I was so worried b/c I thought they might discover that I did something wrong. I didn't send the tubing/platelet bag to blood bank as usually done in reactions, but they never requested it. This happened about 3 yrs ago & I woke up this a.m. freaking out. I can't believe I was so worried about saving my butt than learning from my mistake. Can this reaction have any lasting effects on the pt? I feel so guilty. If only I could rewind, admit my mistake, make an incident report and feel better. I would NEVER let that happen now, I'm a different person & nurse. Sorry for the long post, but I needed to get it off my chest & only nurses will understand what the heck I'm talking about.

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Specializes in Critical Care.

Was this recently brought up for some reason? If not, what has happened that would make you think about this three years later?

tvccrn

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Specializes in ER, Research.

I'm not quite sure, It's just one of those things. I guess the latent guilt is getting me, big time.

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Specializes in CRNA.

I would not worry about it. Leukocytes are still transfused regardless of whether you are using blood tubing or regular tubing. The only way to avoid transfusing leukocytes is to use washed cells and even then, some leukocytes still make it into the bag. There is actually a fairly new study out that states the incidence of death is greater in post open heart patients (specifically women) who are transfused with blood products intra or postoperatively. The researchers think it is due to interactions with the leukocytes that are present from the transfused blood causing immunosuppression in the host.

Rogers, M. A. M., Blumberg, N., Saint, S. K., Kim, C., Nallamothu, B. K., & Langa, K. M. (2006). Allogeneic blood transfusions explain increased mortality in women after coronary artery bypass graft surgery. American Heart Journal. (6), 1028-1034.

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Blood tubing should be used for all blood products, without fail. That said, it's three years later. Don't worry about it, just learn from it.

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Specializes in ER, Research.

I wonder what those nurses are doing who told me to use regular tubing for platelets? They must not be using blood tubing. Is it dangerous?:uhoh3: That said, I'm so glad I have some maturity and experience under my belt and that I don't continue to screw up in that manner. Using resources and checking before you do is sooo important. I'm going to get over this one and not torture myself, but it's hard when people trust Nurses so much & I broke that trust w/ that pt. Especially when I didn't come clean or didn't send the tubing to blood bank, knowing they would say something...Ugh, makes me lose my appetite.

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Specializes in ER, Research.

P.S., Tazzy I love your prayer. Amen to that!;)

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Specializes in ER, Research.

RedCell, you were born in the same month/year as me. Way to go!

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Specializes in Med/Surg, Geriatrics.
This happened about 3 yrs ago & I woke up this a.m. freaking out. I can't believe I was so worried about saving my butt than learning from my mistake. Can this reaction have any lasting effects on the pt? I feel so guilty. If only I could rewind, admit my mistake, make an incident report and feel better.

Ooooookay. I think the bigger issue is the lasting effect it is having on you. Are you due for a vacation? I'm willing to bet there are other things going on. Protect your physical and emotional health.

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You're acting like you did something on purpose! At the time you didn't know you did something wrong. You do now, and you won't do it again. You're human and made a mistake, and you'll probably make several more mistakes in your lifetime. You shouldn't beat yourself up because you're human.

I have a side question - I don't understand the whole leukocyte transfusing business - what's wrong with transfusing leukocytes? I thought leukocytes were always transfused in any blood products, unless they were "washed cells". And "washed cells" - is that when leukocytes are filtered out, or are other things filtered out too? This is probably an elementary question, but I'm a young nurse too. Well, not that young, but new anyway.

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Specializes in Brain injury,vent,peds ,geriatrics,home.

Dont mean to sound insensitive.My dad died of a blood transfusion reaction.I was a baby and have no memory of him or the event.But I would never have a blood transfusion.And the reaction might not only affect the PT.,.but their family as well....

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Specializes in Orthosurgery, Rehab, Homecare.

Did you have a dream about it?

Live, Learn, Move on. . . If you can't get counciling. The guy probably would have hav a rxn reguardless. Now you know.

~Jen

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