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size of non coring huber point needle for transfusion of blood products

 Hi everyone,

In my unit we routinely transfuse blood with 22 and 24 gauge peripheral access devices. Reviewing our CVAD policy, it states that a 19 ga needle is required when using an implanted port for transfusion. Is there any reason why a smaller needle couldn't be used? I couldn't find a reference to this in the INS Standards.


Kerry McDonald RN

Pembroke Regional Hospital

 Gauge size is gauge size

 Gauge size is gauge size regardless of what type of device your are talking about. So you can infuse blood through a smaller gauge port access needle. However there are differences with flow rates of blood between a short peripheral catheter and any CVAD but it is not related to the devices internal diameter. It is related to the catheter length. Length adds resistance to fluid flow. So a longer CVAD will take a lot longer for blood to flow than it will through a peripheral catheter. Then add the fact that there can easily be drug precipitate, fibrin and thrombus accumulation in the CVAD lumen that also will slow down the flow rate. Then consider that packed RBCs are an extremely viscous fluid which also adds resistance to flow rate. So you will probably require an infusion pump to give packed RBCs through any CVAD within the allotted 4 hour max hang time. You may even need to ask the blood bank to split the unit into 2 aliquotted units to the total transfusion time can take up to 8 hours. Hang one half of the unit while the other other half remains in the blood bank. When an infusion pump is used though, I would not go smaller than a 22 g to avoid RBC damage from the pump forcing the cells through the smaller 24 g. 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

 Lynne, Thanks for your


Thanks for your feedback, I will bring it froward. We do use infusion pumps for blood and splitting units is a good suggestion as well. I will advocate for 22 - 19 ga depending apon patient assessment. (our patients c/o much more discomfort with the larger gauge needles).



K. McDonald RN


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