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Jean-AMH
Using Alaris pumps to infuse blood peripherally

Are there any facilites using the Alaris pumps that allow blood to be transfused through the pump via a peripheral line? We are reviewing our policy to include central lines such as PICC's and triple lumens but would like to know if other hospitals allow blood to be pumped peripherally.

lynncrni
I am not in a hospital, but
I am not in a hospital, but I know that blood can be pumped via a peripheral vein. Each pump manufacturer must have specific instructions for using their pump for blood infusion. Most of the major brands do have this, but you will need to obtain the written information for the brand of pump you are using. I cannot think of any issues that apply to peripheral sites and not to central catheters. What are your concerns with pumping blood into a peripheral vein? Lynn

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

smarison
I was hoping this is what I
I was hoping this is what I was looking for.  I know I saw somewere in here about giving blood thru IV's and not needing to have a specific gauge as long as the IV is functioning.  Someone quoted the standards for ABA I think.  Lynn maybe?  Thanks Susan
cmnurse
We use Alaris pumps and
We use Alaris pumps and infuse all blood products, except for platelets, with the pump through a peripheral IV, PICC, central line, portacath... everything. No issues with this that I am aware of- had these pumps over 5 years now.
Jean-AMH
We recently had a blood
We recently had a blood infiltration with it being pumped into a peripheral IV. THe IV team feels that had it been running by gravity the infusion would have stopped or slowed but that the pump keeps going and going. We do have the manufacturers instructions- it is approved for use- we're just being conservative at this point and will be discussing the policy at our care and practice council next week. Thanks for your input.
Gwen Irwin
Margy Galloway had a great

Margy Galloway had a great article about using smaller gauge peripheral IV catheters for blood transfusions in JAVA last fall (right, Margy?).

 Gwen

Austin, Texas

 

Peggy McDaniel
Just to add to Lynn's

Just to add to Lynn's comment- most manufacturers will have data supporting such practices.  Alaris produces more than one type of IV pump, so if you are looking for such information you need to specify the actual pump as well.  Not just the manufacturer.

 Peggy McDaniel RN BSN

Infusion Practice Manager, Western Region

Cardinal Health

Peggy McDaniel RN BSN

Infusion Practice Manager, Western Region

CareFusion

Jean-AMH
I have a white paper from
I have a white paper from Cardinal which is helpful for supporting the practice- but I don't know what pressure setting the pumps should be set at for infusing blood. We use the Alaris Smart pumps.  Currently the pressure is preset at 520psi.  Any recommendations on where to set the pressure alarms for blood products?
lynncrni
Do you actually mean 520 mm

Do you actually mean 520 mm Hg, not psi. 1 pound per square inch = 50 mm of mercury (Hg) So 520 mm Hg would equal 10.4 psi. Even that seems high to me. This pressure is actually the pressure limit, not the pumping pressure. The pump must detect resistance to flow, then it increases the pumping pressure to overcome that resistance until it reaches the pressure limit. Then an occlusion alarm occurs. The damage to RBCs comes when the pressure tries to force them through a small catheter like a 24 g, along with the pumping mechanism - piston, peristaltic, etc. I have never seen a recommendation for a pressure alarm for blood. The gauge on pressure bags used for pumping blood enters the danger zone at 300 mm Hg or 6 psi, but you need to go by the pump manufacturers instructions for use. Also many pumps to not have adjustments on their pressure alarms, so you will not have a choice. Lynn

 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Lorraine Bortner
Our hospital is using the
Our hospital is using the pumps for blood through peripheral Iv's for approx. 5 years with very little problem.  It has been especially beneficial to the patients because of the control of the flow rate, decreasing blood waste for hanging too long and more importantly decreasing fluid overload in some of our fragile patients.
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