thank you so much, as a senior who is about to graduate in December, but hast to brush up on her blood and ministration for skills testing today this was perfect!!!
I wish there was information like this when I went to nursing school! If I ever go back to bedside nursing I will be using you videos and cards as a refresher!
Hello, thank you for such an informative video! I'm a hematology nurse in Korea, and here we have never used such a pump for transfusion. We use a filtered transfusion set and connect it directly to the extension line of the patient's IV line, then manually set the drip rate. Is using the pump a common practice in the States?
I appreciate the explanation as to why we do the prep work of starting the saline before getting the blood. I got a question about that wrong and thought you would prep EVERYTHING (including blood) at the same time. I will not forget now!
Absolutely! I've made this mistake in practice. I got the blood THEN set stuff up, only to find their IV had blown and we almost missed our start window because we had a difficult time getting a new IV started. Definitely one of those things you do once and never do again! - Ellis
As a lab MLS I would like to make 2 points. There are times when blood will be matched for a patient that isn't the patient's type - giving O+ O- is common. Also, giving type specific plasma is somewhat rare - most blood banks carry AB and A almost exclusively. Platelets, because of their short shelf life, are commonly alternate types as well. As far as transfusion reactions, it's been my experience they are almost entirely febrile non hemolytic or allergic which are determined by exclusion and clinical presentation. TRALI and TACO are rare possibilities as well.
Thank you for your video's. If there is a reaction, after I have d/ced the line. Do I have to start another IV or can I run saline through the existing catheter?
Remove the blood tubing and run saline through the existing catheter. The only time you wouldn't do that is if that site became infiltrated during the initial infusion.
I noticed that you didn't include listening to lung sounds prior to administration? In our Nursing School instructions, it states that we take the first set of vitals and listen to lung sounds prior to administration? Is this not a step that is normally exercised?
Flushing the line has no rate - you just run the normal saline through the line to get the air out. Your second question doesn't have one direct answer. It is recommended to begin the blood slower at first. This is because if there were a reaction, slowly running the blood means a smaller amount got into the patient. Once those initial 15 minutes go by and the patient is not showing signs of reaction, we will generally increase the rate. The rate itself depends on a lot of different things including the patient's hydration status, fluid status, age/size (think infants versus adults), and how much blood they're receiving. Remember, the blood must be administered within 4 hours of picking it up from the lab. If I run it too slowly, I could risk not all of being administered before that time is up. If I run it too quickly, I risk the patient going into fluid volume overload. Ultimately, the rate is a nursing clinical reasoning decision but you can always include your practitioner! - Ellis
Occasionally what infusion amount would you normally start at? I’ve seen orders saying give 1 unit blood and recheck H&H after 1 hour. Therefore, not really seeing how much to start with or dose not to exceed 🤷🏽♀️
Great question. Orders won't generally include a rate for blood administration as the recommendation varies. Most facilities follow a 1-2 mL/kg/hr for the first 15 minutes. This is going to be somewhere between 50 and 120 mL/hr depending on patient weight. If the patient is not experiencing a reaction, then you can increase the rate to ensure the bag is infused in the appropriate time frame (4 hours for RBC). There are calculations for this as well (2 - 5 mL/kg/her) but don't forget to also consider your patient's status and medical history. Unless you're working with pediatrics or another unique population, any of us use a standard rate unless it's a special circumstance. For example, when working with adult med-surg patients, I usually start blood at 75 ml/hr and then run it at 150 ml/hr. Hope this helps! - Ellis
There are different recommendations. For an adult patient at low risk for fluid volume overload, the recommendation is between 50 mL/hr and 120 mL/hr. I'll also say that I have never had an order for infusion rate for blood. The rate is often a nursing decision. - Ellis
Why didn't you just prime the normal saline into the filter, stop at that point, and then use the blood to prime the rest of the tubing manually.. instead of using the pump? That way you can connect it to the patient and start it right away?
I think the flow rate in practice is 15-20 drops per minute. I agree with you that in some instances like in paediatrics, Heart failures, etc, one must be careful when adjusting flow rates. However, the flow rate above is safer in all circumstances and will ensure that blood administration does not exceed 4 hours.
I want to join this group ma'am am ANM student of school of nursing Catholic hospital borgang but after finishing this course i start GNM & bsc plz help me any procedure from Monday to start our iv infusion and blood transfusion an so , many procedure I have before exam
Normal saline is approved by the blood bank as a compatible fluid to give while administering blood so is used most frequently. There is some evidence that Ringer's lactate (RL) may cause the blood to clot. However, RL may be used in a rapid blood infusion during an emergent or trauma scenario. As always - follow facility policies and check with your practitioner! - Ellis
In this modern generation where network services are needed a slow and pausing network signal should resort to the replacement of management officials of that particular network.
I have been struggling with a blood donation related argument for a long time.i had been searching on you tube , in a hope of resolving that idea. My problem is that lets think for a moment , i am the recipient having ab positive blood and you are the blood donor with o negative blood. After your blood is inserted in to my body there is actually a chance for reactions between antigens of my blood cells and antibodies of your blood plasma which may cause blood clotting. To tell the truth. According to my knoledge , i think it can be successfull , only if red blood cells without plasma from o negative donor is given to the ab positive recipient.i will be relieved , if you would answer for that. Have a nice day.
In this modern generation where network services are needed a slow and pausing network signal should resort to the replacement of management officials of that particular network.
In this modern generation where network services are needed a slow and pausing network signal should resort to the replacement of management officials of that particular network.
In this modern generation where network services are needed a slow and pausing network signal should resort to the replacement of management officials of that particular network.
