Here is a related question I would like to pose to the group.
If a #24 is adequate to deliver the infusion, why place anything larger?
The guiding principle is to place the smallest device that will do the
job. What advantage is there to placing a larger catheter? Do you find
the larger catheters more reliable, less likely to kink or pull out,
easier to insert? Is there a practical aspect to it, or is it something
that we do just because that's the way it's always been done?
Jerry Bartholomew RN BSN CRNI
Vascular Access Specialist
Veterans Affairs Medical Center
Spokane, Washington
-----Original Message-----
From: Nicastro, Margaret [mailto:[EMAIL PROTECTED]
Sent: Friday, December 30, 2005 6:27 AM
To: Rinehart, Nancy; Stone, Gloria; Bartholomew , Jerry A (SPO); Lynn
Hadaway; DENISE GALLAGHER; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: RE: BLOOD ADMINISTRATION
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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