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INS standards question

please clarify the following questions:

1)  Can blood be infused through a #22 angio if it is on a pump? 

2)  Can albumin be infused through a #22 angio?


Some nursing staff seem to feel these need to run through a PICC line or a #20 angio.  Some pt.'s veins cannot tolerate such a large bore I.V.  What are the INS standards for this so we may clear up these questions.

Thanks in advance!

This is a procedural
This is a procedural question and the INS standards are not written as procedures. I just addressed this question a few days ago in my blog. So go to for more information. Thanks, Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Lynn, your blog on

Lynn, your blog on transfusions is spot on. I think that we see these points of confusion in IV therapy because the speed of technology out runs our education systems for nurses. IN the 1970's, we were told not to use anything less than 20 g IV caths due to hemolysis of the blood cells. With the advancement of both Blood Bankiing preservatives and cell preservation and IV catheter size and material, many nurses in the outskirts of our large, university based teaching hospitals never get the word or updates on what's possible for today's IV therapy. In long-term-care sites, 22g short peripherals are sometimes all we can get and they transfuse over 2-4 hours without pressure just fine.

Ken Thomas, RN

Institute of Nursing Excellence, Inc.

Peter Marino
I have to take issue with

I have to take issue with the statement from Lynn's Blog

 "For transfusion through a 24 gauge, I would choose gravity infusion and not use an infusion pump. Forcing the red blood cells through the smaller size catheter could result in some cell damage. Allowing them to flow by gravity allows time for the cells to change shape as they naturally do when flowing through small capillaries."

We have kicked this around on this very list and using the search feature would have turned up this thread In it you will find the AABB manual page that states;"Specific models of infusion pumps have been approved for use in blood transfusion. These pumps maintain a constant delivery of blood, and studies have indicated no significant evidence of hemolysis as the needle size varies."


Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.

Gwen Irwin
We have infused blood via a

We have infused blood via a 24 gauge catheter and via pump without any problems.  The patient's follow up CBC indicated the expected 2 gm. increase in Hgb.  This patient didn't have any problems with the transfusion via a 24 gauge catheter.  This was unusual for us to have a patient with a 24 gauge, but validated that a 24 gauge catheter was still acceptable to transfuse.

I still think that Margy Galloway's article is a great reference to support this.  I wish I could remember which journal & the month of publication.

Gwen Irwin

Austin, Texas

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