Which gauze cannula is commonly used for blood transfusion?

Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)

Medical Surgical Nursing

Easy

Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)

Explanation

The 18-gauge (green) cannula is a standard choice for blood transfusions in adults.
Its bore size is large enough to accommodate the viscosity of blood products, allowing for a flow rate of approximately 90 mL/min.
This size minimizes the risk of mechanical hemolysis (damage to red blood cells) as they pass through the cannula.
It allows a unit of packed red blood cells to be transfused within the recommended 2-4 hour window, reducing the risk of bacterial growth.

Option A: A 16 G (Gray) cannula has a very high flow rate (180 mL/min) and is larger than typically needed for a routine transfusion. It can cause more patient discomfort and is generally reserved for rapid volume replacement in trauma or major surgery.
Option C: A 22 G (Blue) cannula has a smaller bore and a lower flow rate (36 mL/min). Using it for blood transfusions in adults increases the risk of hemolysis and can significantly prolong the infusion time, potentially exceeding the safe 4-hour limit.
Option D: The option '23 G - Orange color' contains incorrect information. An orange cannula is 14 G, not 23 G. A 23 G cannula (typically light blue/turquoise) is very small and not recommended for blood transfusions in adults due to a high risk of hemolysis and very slow flow rate.

Clinical Relevance

Nursing practice connection: Knowing Selection of appropriate IV cannula gauge for blood transfusion helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Choosing the correct cannula size is a critical nursing responsibility that directly impacts patient safety and treatment efficacy.
Using a cannula that is too small for a blood transfusion can lead to serious complications, including hemolysis, which can cause renal failure, and prolonged transfusion times, which increase the risk of bacterial contamination and sepsis.
A nurse must always assess the patient's vein condition, the type of fluid to be infused, and the required infusion rate before selecting a cannula.

How to Approach the Question

First, identify the core of the question: it asks for the 'common' cannula size for a 'blood transfusion'.
Recall the properties of blood: it is more viscous (thicker) than standard IV fluids.
Understand the relationship between cannula gauge and size: a smaller gauge number means a larger cannula diameter.
Consider the requirements for a blood transfusion: the cannula must be large enough to prevent damage (hemolysis) to red blood cells and allow a reasonable flow rate.
Evaluate the options: 16G is very large (for trauma), 22G and 23G are too small (risk of hemolysis). 18G offers a good balance of size and flow rate for routine transfusions.
Select the option that best fits the criteria for a common, safe, and effective blood transfusion in an adult.

Concept Tested & Keywords

Concept Tested: Selection of appropriate IV cannula gauge for blood transfusion.
Stem keywords: cannula, blood transfusion, commonly used
Lead-in keywords: Which

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E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 76-78