I place lines for an acute rehab hospital, at times the patients have too small vessels for a midline/PICC and need I have to place an PIV for PRBC's, I generally carry 22g PIV's for these facilities. I have given PRBC's through this size many a time with no complications. I know the general thought is to have a large bore catheter for blood, but is there any contraindication for the gauge of the PIV for blood products? I have never heard of any, and I need to check INS. What is the current recommendation. Thanks, Denise RN, VA-BC
I believe its a minimum of a 20g for PRBC due to cell lyses if given through anything smaller
Andrew Edwards, RN
There is no restrictions on the size of PIVC used to transfuse a unit of PRBCs. Even a 24 g is used in neonates for transfusion. 20 g is most common, however you should choose the size that is most appropriate for the vein of patient. If you must use a 24 g, do not use a pump to infuse the blood as the pressure from the pump can damage RBCs. Gravity flow will not cause damage so use all the 22 g you need to use, there is no problem.
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
Thanks, this is what I do. It is hard to get the nurses at these facilities to stop placing a large gauze PIV that always causes problems, redness/swelling. Significant tissue injury. Thanks for the info.
Denise
I too have given many units with a 22gauge IV catheter. In neonates and infants, they use a 26 gauge with aliquot of blood. And you draw labs with a 26g butterfly and not lyse the cells,... INS and AABB state to use the smallest gauge and shortest length catheter for the specifics on hand. Now, in an emergency setting where you need that unit of blood to dump in quickly, and have crystalloids/colloids infusing quickly, I would have a larger bore to accommodate better flow rates. However, my elderly patients won't be getting that unit dumped into them any faster than 3-4 hrs time frame.