Medications and Intravenous Solutions
Only normal saline (0.9% USP) should be used to prime the intravenous line before blood components are infused and to clear the line after infusions.
If intravenous medications are required, they must not be added directly to blood component bags. Use of a Y-extension allows medications to be administered through the alternate limb of the Y and flushed with a compatible solution before blood is infused.
Additional information on infusion may be found in the Circular of Information for the Use of Human Blood and Blood Components Section A.4 #5
Incompatible Solutions
The following are solutions that are not compatible with red cells:
- Ringer's lactate
- Glucose
Ringer's lactate and other solutions containing calcium promote clotting by counteracting the calcium binding effect of the citrate anticoagulant. Glucose (dextrose) solutions cause agglomeration of the red cells and decreased red cell survival, or even acute hemolytic reactions.