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flushing access lines after blood transfusion

How much NSS is required to flush a CVAD an PVC after giving blood transfusion or getting a blood specimen?

How about after a blood transfusion reaction? How much do you flush?


thank you


Following blood transfusion

Following blood transfusion or blood sampling, you need to flush with as much as needed to make sure all visible blood is gone from the external catheter and needleless connector if one was used. There is no evidence based volume. 20 mL is most common but not a standard. 

Following a blood transfusion reaction, you first need to disconnect all administration sets and needleless connectors from the catheter hub. Those components contain more of the blood causing the reaction so the goal is to prevent more transfused blood from being infused. Aspirate the lumen to remove as much as possible and then flush. Again, no EBP volume, just flush with what it takes to clear the line. But this is usually done with an infusion of NS not a manual push. Depending on the specific type of reaction, fluid infusion may be necessary. So hook up a plain infusion of NS to the catheter, report immediately and get orders for fluids if the LIP thinks it is necessary. 

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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