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Usually a large bore needle is used in emergent situations, such as an 18-gauge or 16-gauge. The old standard was to use a catheter no smaller than a 20-gauge. Research shows that a 22-gauge needles will suffice without significant hemolysis (blood cell rupture). Remember that the bigger the gauge number, the smaller the diameter.

Miller MA, Schlueter AJ. Transfusions via hand-held syringes and small-gauge needles as risk factors for hyperkalemia. Transfusion 2004;44:373-381.

Frelich R, Ellis MH. The effect of external pressure, catheter gauge, and storage time on hemolysis in RBC transfusion. Transfusion 2001;41:799-802.

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