We are a hospital based outpatient infusion center. We use mostly 22g
catheters on our infusion patients. We have had to administer blood and blood
products along with antibiotics and sometimes chemo vias a 24g due to the
patients veins. I have had less problems placing a 24g catheter into a small,
frail vein and infusing medications and blood than trying to place something
larger. I have infused at a rate of 200ml/hr without a problem via a pump.
Margaret
Margaret M Nicastro, CRNI, OCN
Coorordinator IV Therapy/Oncology
Gettysburg Hospital
147 Gettys Street
Gettysburg, PA 17325
Phone: 717-337-4312
Fax: 717-337-4485
________________________________
From: [EMAIL PROTECTED] on behalf of Rinehart, Nancy
Sent: Thu 12/29/2005 3:38 PM
To: Stone, Gloria; Bartholomew , Jerry A (SPO); Lynn Hadaway; DENISE GALLAGHER;
[EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: RE: BLOOD ADMINISTRATION
our Ambulatory Infusion Center uses 24s with any and all types of infusions,
ie blood, Remicade, iron. depends on the patient
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Stone,
Gloria
Sent: Saturday, December 24, 2005 10:26 AM
To: Bartholomew , Jerry A (SPO); Lynn Hadaway; DENISE GALLAGHER; [EMAIL
PROTECTED]; [EMAIL PROTECTED]
Subject: RE: BLOOD ADMINISTRATION
ped puts blood through 24 PRN...............gloria stone RVMC Medford
Oregon
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of
Bartholomew , Jerry A (SPO)
Sent: Thursday, December 22, 2005 11:02 AM
To: Lynn Hadaway; DENISE GALLAGHER; [EMAIL PROTECTED]; [EMAIL
PROTECTED]
Subject: RE: BLOOD ADMINISTRATION
I have personally transfused several units through a 24 gauge
catheter. I did some research on the relative diameters of red blood cells,
and the 24 gauge catheter. The catheter diameter is equal to the width of
60-80 red blood cells. Under normal pressures, this will not cause hemolysis.
The limiting factor is the speed of the transfusion. If you're working the ER
and you need to slam the unit into a trauma victim, then the #24 is not for
you. But if you are satisfied with rates of 200-400ml per hour, you shouldn't
have any problems, because a #24 will accommodate up to 1200ml/hour. Just as
an aside, I also infuse quite a bit of IVIG, and Prolastin, and use the #24s
almost exclusively. You can also find support for this in the manual put out
by the American Association of Blood Banking.
Jerry Bartholomew RN BSN CRNI
Vascular Access Specialist
Veterans Affairs Medical Center
Spokane, Washington
________________________________
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of
Lynn Hadaway
Sent: Wednesday, December 21, 2005 8:09 AM
To: DENISE GALLAGHER; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Re: BLOOD ADMINISTRATION
The only time I would hesitate to use a 22 ga for blood
transfusion is when there is major bleeding or trauma and you need to rapidly
infuse the blood. Otherwise, there is no problem with infusing blood through a
22g. It will take longer to infuse than through a larger gauge but should
easily infuse in the 4 hour limitation. Lynn
At 9:27 PM -0500 12/20/05, DENISE GALLAGHER wrote:
My understanding is that blood can be given through a
22 ga if it is a thin wall catheter because then the diameter is a bit larger.
But, would probably only use if for the occasional one unit and not on a
routine basis.
----- Original Message -----
From: Lynn Hadaway <mailto:[EMAIL PROTECTED]>
To: [EMAIL PROTECTED] ; [EMAIL PROTECTED]
Sent: Tuesday, December 20, 2005 11:10 AM
Subject: Re: BLOOD ADMINISTRATION
Go to your blood bank and ask if they have a
copy of the textbook, Technical Manual, from the American Association of Blood
Banks, not sure what the most recent edition is. Mine is very old, yet it still
states in the chapter on administration that blood can be infused through as
small as a 21 gauge. Since catheters come in even sizes, I would change that to
a 22 g. It is very often given to neonates through a 24 gauge. There are
several studies supporting this but your best reference is the AABB book. Lynn
At 8:19 AM -0500 12/20/05, [EMAIL PROTECTED]
wrote:
At the institution I currently work for
we have had an issue with what size IV is appropriate for blood administration.
I am curious as to what policies are out there and what evidence based
practice studies have been done. The main question is #20 gauge is the
smallest gauge that is appropriate for administration.
Thank you ,
Tamara
[EMAIL PROTECTED]
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
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