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Dr. Ann Schneider, DVM, answers commonly asked questions about veterinary blood transfusions.
1. How do I administer the blood/plasma?
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The Eastern Veterinary Blood Bank is currently distributing Terumo "Y-type" blood administration sets,
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which have two spikes which can be put into the blood/plasma bag; the other end of the Y is designed to hook up to an IV line or catheter. Close the clamps on all three parts before you start.
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There are two types of blood bags available.
One type has ports covered by a clear, thick plastic. Peel apart the two sides to expose the sterile ports.
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The other type has white plastic tabs. Pull the tab off to expose the sterile port. Remove the plastic top over the beige spike on the administration set, and insert the full length of the spike into the port.
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Open the clamp just below the spike in use. Gently squeeze the drip chamber to allow blood/plasma to enter the chamber. (See Terfusion package for more details.)
Open the clamp on the base of the Y to allow blood to fill the line. Attach IV line or catheter.
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2. The Packed Red Blood Cells won't flow well...
PRBCs are very thick, and do not always flow easily through the blood filter and catheter. Dilution of the cells with 0.9% NaCl (no other fluid can be safely used) will facilitate flow: see below.
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3. How do I add saline to the Packed Red Blood Cells to help them flow?
- Most blood bags have an extra port to allow insertion of a "Spike." A "Spike" (see EVBB products list) can be inserted into the blood bag port to allow injection of 50-100 ml of 0.9% NaCl into the bag. Gentle manipulation of the RBC clumps will allow them to resuspend and flow more easily.
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- If using a Terumo "Y-type" administration set, the extra spike can be inserted into a bottle or bag of 0.9% NaCl. Running the saline at a slow rate (50-100 ml total of saline) while running the PRBCs will dilute the cells and speed the flow. See Terfusion package for details.
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4. Are these blood clots in the Packed Red Blood Cells?
PRBCs are very viscous, and do not always resuspend easily. "Lumps" of packed cells, which visually resemble clots, are actually much softer than clots. Gentle manipulation of these soft lumps will help them to fall apart into the fluid.
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5. Why is the "Total Volume" on the Packed Red Blood Cell bag not the same as what I ordered? And I ordered two bags of 125 ml... the two bags have different "Total Volumes"!!
- Some of our blood bags contain CPDA-1, and others contain CPD and Adsol or Optisol or CP2D and Nutricel. Adsol, Optisol, and Nutricel are added after the blood is separated, so they will increase the Total Volume, but not affect the amount of PRBCs in the bag. Therefore, a bag of 125 ml of PRBCs may have a total volume of 125 ml (if CPDA-1 was use) or 175 ml (if CPD/CP2D and
Adsol/Optisol/Nutricel were used). The same applies to bags of 250 ml of PRBCs... 250 ml (if CPDA-1) vs. 350 ml (if CPD/CP2D and
Adsol/Optisol/Nutricel).
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Any questions you have about an individual bag may be answered by checking the small white label below the ID label on the blood tag; these labels indicate if CPDA-1 was used
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...or if CPD/CP2D was used and Adsol/Optisol/Nutricel was added (the volume of
Adsol/Optisol/Nutricel added will be indicated as well.)
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Please note: the shelf lives of blood collected into different anticoagulant and preservative solutions vary slightly. Check the blood bag for expiration date.
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