I remember reading an article By Lynn Hadaway stating studies that show there is not necessarily hemolysis of blood infusions through 22 or 24 gauge catheters. Can not find the article. I am trying to defend our policy on this.
I remember reading an article By Lynn Hadaway stating studies that show there is not necessarily hemolysis of blood infusions through 22 or 24 gauge catheters. Can not find the article. I am trying to defend our policy on this.
Go to the Blood Bank in your Lab. Ask to see the Technical Manual from the American Association of Blood Banks. Read the chapter on Administration of Blood Components. There is a section on catheter sizes. So my statements are only reporting what AABB is saying. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I know that Lynn, but I thought the studies that actually revealed no hemolysis were very interesting.
Chris
Oh dear, I found the resource and it actually was written by Marge galloway in JAVA 2006 vol. II.
Chris
There will be a presentation at the Association for Vascular Access (AVA) on this exact subject. There is a 4 hour pre conferenece on venous access for the patient with limited options. Please refer to the AVA web site at www.avainfo.org for more info on this session.
Cheryl Kelley
2010 AVA Scientific Meeting Chair
Cheryl Kelley RN BSN, VA-BC
NICU uses 24 gauge to give red cells. Those cells are no different. We routinely give blood through a 22ga. We will use a 24 if we have to, it will have to go much slower.
Barbara Tinsley
Check this article for information about using 24 gauge PIV for blood transfusion.
Acquillo, Gloria. Blood Transfusion Flow Rate. JAVA Volume 12, no. 4, Winter 2007; pp 225-226.
It is an invitro project that tested using a 24 gauge catheter without resulting hemolysis.
Gwen Irwin
Austin, Texas
the AABB, chapter 5 page 2 says, "red blood cells can be safely administered through 23-25 guage needles; however, the flow rate will be slower". When I wrote our facility policy, I talked to the physician over the blood bank in our area. She stated that it was not the gauge of the needle but the rate of infusion that was a problem. She felt that small gauge needles work great but when you try to pump blood in rapidly, then you can see lysing of the RBC's. Hope that helps. Katie CRNI SLC, Ut
Exactly the most important point!! Infusion pressure, not the catheter size, is what lyses RBCs. After all, the RBC must change shapes to pass through the microcirculation in the alveoli. So they can certainly become more elongated to pass through a small catheter. But if pressure is applied, they could easily rupture. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
We have had patients successfully receive 2 units of blood through 24 gauge catheter given via pump at 125/hour. The next day the H&H reflect 2 gram increase, like expected.
Gwen Irwin