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Level One Rapid Infuser/Massive Transfusion

Level One Rapid Infuser/Massive Transfusion. Presented by: Jonna Bobeck BSN, RN, CEN. Describe purpose of Level One Rapid Infuser Discuss set up and use Explain patient preparation and assessment Describe troubleshooting Discuss massive transfusion. Objectives.

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Level One Rapid Infuser/Massive Transfusion

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  1. Level One Rapid Infuser/Massive Transfusion Presented by: JonnaBobeck BSN, RN, CEN

  2. Describe purpose of Level One Rapid Infuser • Discuss set up and use • Explain patient preparation and assessment • Describe troubleshooting • Discuss massive transfusion Objectives

  3. Warm and quickly infuse large amounts of blood and/or fluids Introduction

  4. Aseptic technique • Proper device use • Crystalloid and colloid solutions • Sequelae of massive transfusion and fluid resuscitation Prerequisite Knowledge

  5. Level one infuser • Disposable fluid administration sets • IV fluids or blood products as prescribed • Non sterile gloves • Large bore IV access times 3 • Monitoring equipment Equipment

  6. Vital signs • LOC • Core temperature • Lab values • IV patency Patient Assessment

  7. Patient and family teaching • Minimum 2 large bore IV sites • Monitor BP, SPO2, Cardiac rhythm • Warm patient • Foley catheter • Obtain blood sample • ABG Patient Preparation

  8. Remove air from fluid bag • Close clamps of administration set • Spike bag • Open clamps and invert drip chamber to fill ½ full • Prime the rest of the line • Gas vent will self prime (gently tap against the level one cabinet to release trapped air) Priming

  9. Flip toggle switch to “-” position • Push heat exchanger in to socket 1 • Slide top socket and snap heat exchanger into number 2 • Place gas vent into number 3 Procedure

  10. Clamp • Turn off • Replace bag • Close door • Turn on and resume infusion Changing Bags

  11. Disposable light • Water level light • Overtemp alarm Troubleshooting Alarms

  12. Vital signs • Core temperature • IV integrity • Hemodynamic parameters • Urine output Patient Monitoring

  13. Documentation

  14. Purpose: low blood volume due to hemorrrhage Massive Transfusions

  15. Hypotension • Major obvious blood loss • Continued bleeding • Surgeries where there is high risk of blood loss Process for Utilization

  16. Physician responsibility • Nurse responsibility • Blood bank Initiation of MTP

  17. Monitoring Labs

  18. Clinical coordinator • Nursing Responsibilities

  19. Hct of 27-30% • INR < 1.7 seconds • Fibrinogen > 100mg/dl • Platelet count of > 100,000/dl • Core temperature of > 35 degrees Celsius Goals for Hemostasis

  20. Termination

  21. Pullman Regional Hospital, Initials. (2009). Massive transfusion protocol Retrieved from \\prhs5\groups\Policies and Procedures\Patient Care • Schulman, C. (2000). Rapid infuser for massive fluid resuscitation. Retrieved from http://www.georgiahealth.edu/som/path ology/documents/Massive Fluid Resuscitation-RapidInfuser.pdf References

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