I apologize for what may be an old issue, but I was interested in getting recent feedback given the new recommendations in INS SOP. When performing therapeutic phlebotomy using short peripheral catheters, do you still rely on gravity flow and/or tourniquet or BP cuff pressure to regulate flow? I see that vacuum is not recommended during TP for risk of AE. Of course, I am concerned that blood flow through these smaller gauge plastic catheters may be impeded somehow, but perhaps not? I was trained to use 14# built-in steel needles for TP and those with whom I work were trained the same way, and I'm having a hard time shaking the paradigm. Thanks in advance for any advice, reassurance, and procedures you are willing to share.
Think of the vein trauma from a 14 g needle/catheter!! I have done many TP with an 18 g and 20 g catheter. Tourniquet or BP cuff may be used for slow flow. Also flushing with saline may help with flow. Normal blood donation is done all the time with bags by gravity and not vacuum bottles. 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 use an 18 g., a blood collection bag with no anti-coagulant or preservative, and a scale. The bag sits about 18 inches off the floor on the scale with the pt sitting in a recliner. It takes about 10-20 min to collect the unit of blood. A PIV makes it much easier if two units are to be collected with a bag of saline infused in between them.