What is the recommended cannula size (gauge) when preparing to initiate a transfusion of packed red blood cells (PRBCs) in an adult patient to prevent mechanical hemolysis?
Answer and explanation
Correct answer: B. 18-gauge or 20-gauge cannula
- Step 1: Packed red blood cells contain cellular components that are vulnerable to shearing forces and lysis when forced through narrow-bore catheters.
- Step 2: Standard transfusion protocols specify an 18-gauge or 20-gauge large-bore peripheral cannula for adults to facilitate adequate flow rates and minimize erythrocyte trauma and hemolysis.
Answer
18-gauge or 20-gauge cannula.
Why not the others: 24-gauge and 26-gauge are narrow pediatric needles that produce shearing hemolysis during rapid RBC administration; 22-gauge is reserved for pediatric or fragile adult veins when larger bores fail.
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