[Chirley]

Thanks for the answers. I think that it seems to depend on which nurse is looking after me as to how fast the blood and saline are run. The policy is for each unit to run over one and a half hours but sometimes the blood is run over half to three quarters of an hour.

I have a premed of hydrocortisone before the transfusion due to a previous reaction and then they wait half an hour before starting the blood. It's during this half hour that they start the 1 litre bag of saline and just run it in fully open. They then use this bag of saline to flush between each unit of blood and to flush at the end as well. The bag of saline is almost always empty by the time the transfusion is finished.

I agree 4 units is a lot and I wasn't expecting it. I am routinely booked to have 3 units every 3 weeks but this time the Hb had dropped a lot lower than it usually does so the doctor wanted the 4th unit as an add on. My doctors policy is one unit of blood for every 10 grams of Hb below 100 and then an extra unit to increase the Hb above 100.

Personally I would prefer the blood to be run slower because it does sometimes cause blood pressure changes and also makes me feel very cold. I was told once that when all the patients have finished their treatments, the nurses can go home, they don't have to wait until a set time. I think if this is true, it encourages the treatments to be given very fast. I know that once my port wasn't working properly and the blood was running slow and the nurse had to stay back after the end of shift and she wasn't very happy. She put a note on my chart to say that the blood had to be run through a pump so that it wouldn't run overtime again.

Please don't get me wrong. I'm very grateful for the genuine care that I receive at the day care and I do believe that they do the job to the best of their ability. I'm also grateful for all the blood donors. I would have been dead years ago if it wasn't for blood donors that give their time for no reward except the knowledge that they are doing something truly charitable. I worked out that I need a minimum of one blood donor a week and if I have another problem as well then I need more than one donor a week. That is a very humbling thought.

Chirley