A male patient needs to receive a unit of whole blood. What type of intravenous (IV) device should the nurse consider starting?
A. A small catheter to decrease patient discomfort.
B. The type of IV device the patient has had in the past, which worked well.
C. A large-bore catheter.
D. The type of device the physician prefers.
Correct Answer: C. A large-bore catheter
Large bore catheters prevent damage to blood components and are less likely to develop clotting problems than a small-bore catheter. The nurse should determine the correct device without asking the patient what type has been used before or asking the physician which type he prefers and start the IV.
Option A: Blood components and PPP may be administered through a variety of central venous access devices (CVAD) or peripheral intravenous catheters. Considerations for the selection of appropriate IV access include gauge or lumen size; a dedicated line for the administration of blood components or PPP. Do not co-infuse medications with blood components or PPP, and CVADs with multiple lumens allow blood components or PPP products to be given through one lumen while other medications or solutions infuse through other lumens.
Option B: Infusion devices have been known to cause mechanical hemolysis;18 therefore, prior to implementing the use of an infusion device, confirmation that it has been approved for use in transfusing blood components should be obtained from the manufacturer.
Option D: A pressure infusion device may be used for rapid administration of blood components. The pressure applied to the blood component should not exceed 300 mm Hg as this may result in hemolysis or bag breakage. A blood warmer device may be used to prevent hypothermia during rapid administration of cold blood components, such as in the operating room or trauma setting.