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Maura

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Maura last won the day on September 5 2018

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    Registered Nurse

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  1. I am a certified emergency nurse and combat veteran and in my experience, it has been standard protocol to administer PRBCs and FFP in the same tubing during massive transfusions. We hang PRBCs on one side and FFP on the other and alternate in a 1:1 ratio using the same tubing. I have done this with both the Belmont Rapid Infuser and Level 1 Infuser. Platelets, however, are administered in separate, regular y-type blood tubing and free-flowed (hung "wide open), and not given via rapid infuser/warmer because it is contraindicated per manufacturer's guidelines. I stumbled across this thread because I have also been looking for specific clinical practice guidelines describing this practice and I can't find any. Yes, tubing is changed between units during routine blood transfusions to ensure there isn't cross contamination and so you may test products and tubing individually if there is a transfusion reaction, but when someone is hemorrhaging and we have implemented the massive transfusion protocol (MTP), we only hope that they live to have a reaction. The only adverse reaction I have ever seen to blood products is TRALI, which is a delayed reaction, so we don't know which unit would have caused it anyway. In reality it was probably a combination of all of the units and the inflammatory response the patient's body was going through s/p bilateral above the knee amputations, shock, acute kidney injury, and massive transfusion, resuscitation, and damage control surgery. If anyone has found any references regarding giving PRBCs and FFP in the same tubing, please share! My email is mauraleo@gmail.com Thanks, Maura Leo BSN, RN, CEN
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