If a PIVC fails during a transfusion of blood products, what is the recommended action?

Blood products are a valuable commodity and you really don't want the PIVC to fail before the transfusion is completed. But if it happens, you need to connect a new administration set for the new PIVC. There's not really a better option, as far as infection goes. It's obviously a shame about the blood loss in the discarded administration set.

The important thing is to ensure the PIVC is patent before starting the blood transfusion. Therefore, do a proper assessment: gauge (20G or larger is best), function (flush without resistance and without pain), and site inspection (absence of any pain, redness or swelling).

While the blood transfusion is in progress, you will be assessing the patient frequently, as per your local policy. Your assessment should also include the insertion site. Advise the patient to tell you if they experience any pain at the infusion site, as well as other potential side effects (e.g. back pain, headache, rash, itch, etc.).

It's also important to consider the length of time the blood is hanging. There is a maximum amount of time each blood bag can hang (4 hrs for red blood cells). If the time between PIVC failure and recommencing the new PIVC and administration set will be extended, the blood should return to the blood bank fridge until you are ready to infuse it, but do check your local policy.