Weight = volume of Packed Red Cells = Our Problem

[Seveets]

Here's a new one for the group; anyone else in the WORLD doing this:

The nursing department has gotten themselves brand new pumps that they are using to infusion the blood. (I make the assumption that these pumps are certified and are acceptable for blood usage.) Anyways these pumps need to have an accurate volume programmed into them before the blood is infusion.

For years we have used the standard volume of 350cc in each unit, now we are required to weigh each unit. Our assumption is that the weight of the blood bag minus 50 grams for the weight of the empty bag = a more accurate measurement of the blood volume inside the bag. Of course for the mathematical genius out there, this is at sea level at room temperature.

What does the class think? (At this rate, the nursing staff will have the LAB infusion the blood into their own patients.)

[Mary]

That should work!

Good luck.

[donellda]

Oh boy! I hope this is not going to be something we have to look forward to.

[Cathy]

Oh my!

I think I'd like to see some documentation regarding the pump.

[Lcsmrz]

The SG of packed cells is about 1.013, if my memory serves me correctly. You can easily make a conversion table for total bag weight vs approx volume.

We weight our incoming RBCs and record that weight as an approx volume for the nurses.

[carolyn swickard]

When the RNs had to start recording all volumes In and Out; they asked us to start giving volumes on the RBCs too. We also estimate the bag wight at 50 Gms (weighed many empty ones) and then just weigh the bag and subtract 50 gms (1gm:1ml Ratio). It seems to work well and we have a check against the volume recorded by our Blood Center on Pheresised RBCs - they are pretty close to one another. The Plasmas all have the same kind of weight recorded on them from the Blood Center, so we don't weigh them.

[Eagle Eye]

When we started requiring amt given on the transfusion record, our nursing department did the same thing. But our Director told them that we are not going to weigh the unit and the volume is not provided by blood center. My medical director sent a memo that they can use 350 mL as a default volume if they are not using the pump. It seems to work fine.

Don't you guys think that our blood centers should provide the volume since many state require amount given written on the transfusion record or pt's chart???

[Mabel Adams]

Why can't the nurses weigh them and do the math?

[John C. Staley]

I've got an even better idea. Most of the pumps I'm familiar with have an "infusion rate" setting. Based on how long the pump runs until the blood runs out will give them the exact amount transfused. They can know to the ml how much was infused by letting the pump tell them. It's really not all that hard but asking us to give them a number is much easier.

[carolyn swickard]

350 ml really doesn't work well as a default amount anymore. The pheresised RBC units range from 270-290 ml. The RBCs from the whole blood units range from 300 - 420 ml, based on our experience, at least. Though, give how small an amount 50 mls really is, I'm not sure it makes all that much difference.

[armymt2002]

We also weigh the bags as we do the confirmation testing. The form the military uses requires that the volume infused be put on there in the post transfusion data section. Most of the time it is wrong as the nurses don't pay attention to the volume written on the form and use the volume from the pump which includes the saline to prime the line or the put 1 unit there.

Kristine