Cryo and other blood products in the same line

[Low Flow]

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I've been told not to put cryo in the Belmont for fear of clots forming and necessitating replacement of the tubing. Do you exercise the same caution when it comes to running product through standard blood tubing? I was in a case where someone got on me for hanging platelets right after I hung cryo without first flushing in the cryo with crystalloid. Was trying to avoid giving extra crystalloid when I knew I was just going to be giving more product. I feel like I've done this a few times without it forming a clot in the tubing.

 

[GassYous]

Did they also tell you to avoid a calcium containing fluid because of clot risk in the iv tubing? Because blood doesn't have calcium you see.

 

[Beeftenderloin]

Once in a while when following yellows with yellows I’ve had the filter in the blood tubing get pretty gummed up, necessitated replacement on one occasion. never had a line clot off. If you’re slamming them in, who cares. If they’re slow dripping in, I’d give a quick rinse between.

 

[DocVapor]

Just unhook the line and give a quick and forceful blow into the end of it. Just like with old Nintendo cartridges.

 

[woopedazz]

Did they also tell you to avoid a calcium containing fluid because of clot risk in the iv tubing? Because blood doesn't have calcium you see.

I'm confused if you're being sarcastic or not

 

[Urzuz]

I'm confused if you're being sarcastic or not

He’s being sarcastic.

 

[Mehd School]

I'm confused if you're being sarcastic or not

LR for life

 

[coffeebythelake]

No

 

[Katheudontas parateroumen]

Dogma is scary. It makes you wonder all the things we do for no reason. LR has 2.7meq/L; normal whole blood has 4-5meq/L. Go figure.

 

[coffeebythelake]

Dogma is scary. It makes you wonder all the things we do for no reason. LR has 2.7meq/L; normal whole blood has 4-5meq/L. Go figure.

why do nephrologists hate LR, because they are afraid it will cause their ESRD patients to get hyperkalemic? no physiologic sense.

 

[Katheudontas parateroumen]

why do nephrologists hate LR, because they are afraid it will cause their ESRD patients to get hyperkalemic? no physiologic sense.

Every time I hear a nephrologist say something like that it really bothers me. Out of any speciality, a nephrologist should know something like that!!!

 

[drmwvr]

Why would anyone put cryo in the Belmont?

 

[coffeebythelake]

Why would anyone put cryo in the Belmont?

because they can

 

[drmwvr]

because they can

you can stand up in a canoe too....

 

[itwasalladream]

I don't use the belmont, but I've had the blood tubing filter gum up with fibrin plugs when putting cryo and platelets through the same line, on multiple occasions. Never occluded the tubing itself but occasionally the filter gets gummed up enough that you have to replace it.

 

[Mehd School]

why do nephrologists hate LR, because they are afraid it will cause their ESRD patients to get hyperkalemic? no physiologic sense.

Essentially all of my academic staff still believes this.

 

[GassYous]

Essentially all of my academic staff still believes this.

Dumb
Papers have been out for 10+ years refuting this
Doesn't even make sense physiologically

 

[DrOwnage]

I don't put platelets through the warmer so I usually just give those on a separate line/IV. Don't care about running blood through LR for regular transfusions. For Belmont would just use NS because its slightly better for volume expansion or use albumin.

 

[Mehd School]

I think putting NS in a belmont is among one of the worst times to use NS.

 

[vector2]

I don't put platelets through the warmer so I usually just give those on a separate line/IV. Don't care about running blood through LR for regular transfusions. For Belmont would just use NS because its slightly better for volume expansion or use albumin.

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[coffeebythelake]

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Was just about to post something about that
No problem running platelets through the warmer

 

[coffeebythelake]

I think putting NS in a belmont is among one of the worst times to use NS.

The only situation I would prefer NS is foe those neurosurgery cases.

 

[DrN2O]

I also squeeze the tubing with platelets to release ADP and thromboxin to prime them for aggregation once they hit the patient. /s