Blood, Electrolytes, and Intravenous Infusions

3-18. RATE OF TRANSFUSION

a. The rate of transfusion of blood products depends upon the clinical condition of the patient and the product being transfused. In most administration sets, 15 drops equal one milliliter.

b. Most patients who are not in congestive heart failure or in danger of fluid overload tolerate the transfusion of one unit of red blood cells in a 1 1/2 to 2 hour period. One unit of whole blood equals about 500 milliliters (about 450 milliliters of blood plus 60 milliliters of anticoagulant). The transfusion should be completed in less than four hours because of the dangers of bacterial growth and red blood cell hemolysis at room temperature. During the first 15 minutes, the rate of transfusion of red blood cells should be very slow, about 100 milliliters

per hour. This will keep the volume of red blood cells low in case the patient has an immediate adverse reaction. Watch the patient attentively during the first five minutes and then check after fifteen minutes. At that point, the rate may be increased if the physician orders. After the transfusion, record any adverse reaction and discontinue the intravenous infusion.