Massive Transfusion Devices

  1. Wash hands, and don gloves.
  2. Verify prescription for infusion of IV fluids and blood products and use of a fluid warmer. 
  3. Turn on device. 
  4. Open Y-set fluid administration package provided by the manufacturer. Close all clamps. 
  5. Spike fluid or blood with both sides of the Y-set. 
  6. Hang fluid bags on small hooks inside the massive transfusion device pressure chambers, leaving the chamber doors open, or place fluid bags in separate pressure bags. 7.  Push the bottom end of the heat exchanger rod firmly into the bottom socket, and snap the heat exchanger into the guide. 
  7. Slide the top socket up, and place the top end of the exchanger into the placement tract. 
  8. Slide the top heat exchanger socket down over the heat exchanger tube until the pole latch clicks into place. 
  9. Snap the gas vent filter into the holder on the lower portion of the pole assembly with the orange end up. 
  10. Open the clamp on one side of the Y-set. 
  11. Squeeze drip chambers so that they are half full. 
  12. Remove the male Luer-Lok cap at the end of the IV tubing, and open the clamps. 
  13. Remove the filter from its holder and invert it. Prime the tubing; close the roller clamp. Turn the filter back over, and replace it in its holder. Prevents entrapment of large amounts of air. 
  14. Tap the filter or air eliminator against the cabinet several times. Monitor fluid line for bubbles during use. 
  15. Open the roller clamp partially and slowly infuse fluid. Infusing slowly will allow for assessment of any air bubbles. The air filter will eliminate bubbles in the tubing. 
  16. Replace male Luer-Lok cap at the end of the tubing, and close the clamps. 
  17. Close the pressure chamber doors and latch. 
  18. Perform all function and alarm checks per manufacturer's instructions. 
  19. Wait for the temperature readout to reach the operating temperature of 41°C. 
  20. Flip the toggle switch at the top of the pressure chamber to ON/+ or inflate the separate pressure bags. 
  21. Connect the distal end of the tubing to the patient's IV. 
  22. Open the roller clamp to infuse the fluid. 
  23. Set the rate by gradually opening the clamp. 
  24. Document in patient's record.

Changing the Bags

  1. Close the top clamp on the side of the Y-connector with the empty fluid bag. 2.  Open the clamp on the side of the Y-connector with the full fluid bag, and infuse the fluid.
  2. Turn the ON/+ switch above the pressure chamber to the OFF position and remove the empty bag.
  3. Replace the empty fluid bag with a full one.
  4. Close the pressure chamber door and latch, and flip the control switch above the pressure chamber to ON/+.
  5. Document in patient's record.

Replacing the Filter or Air Eliminator

  1. Close the clamps on the disposable fluid administration set just proximal to the filter and between the filter and the patient connection.
  2. Remove the old filter or air eliminator from the holder and place the new filter or air eliminator in the holder.
  3. Disconnect the old filter or air eliminator at the upper Luer-Lok and connect the tubing to the new filter.
  4. Disconnect the patient line Luer-Lok from the old filter or air eliminator and connect to the new one.
  5. Open the clamp just proximal to the filter or air eliminator to restart fluid infusion. Invert the filter until completely filled with fluid, then turn back to proper position and replace in holder. Open the clamp between the filter and the patient connection. 6.  Remove the filter or air eliminator from the holder, tap until all bubbles are eliminated, and reinsert. Check patient line for bubbles before opening the roller clamp.
  6. Document in patient's record.

Troubleshooting Alarms

  1. If the alarm sounds and the disposable light is illuminated, check to make sure the disposable tubing set is properly placed in the machine.
  2. If the alarm sounds and the water level light is illuminated, check the water level in the chamber and replace as needed with sterile or distilled water.
  3. If the system alarms overtemp, turn the machine off and use a different massive transfusion device. 4.  Document in patient's record.

Transporting a Patient with a Massive Transfusion Device

  1. Turn the massive transfusion device off.
  2. Remove the disposable administration set from its holder on the infuser and place it in the bed alongside the patient or hang it on the transport IV pole.
  3. Plug the infuser into an electric outlet on reaching the intended destination.
  4. Return administration set into the infuser. Turn the machine on. Return fluid bags to pressure chambers.
  5. Document in patient's record.
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