Needed Articles

• Fused-quartz turbulating cuvette
• 250ml saline bag
• 500 units of Heparin
• 19 or 21G butterfly needle
• 60cc syringe with an 18 gauge needle
• Small syringe with needle for transferring Heparin to the 60cc syringe
• Clamp (plastic hemostat)
• Tape, tourniquet, cotton ball
• IV tubing with Y port and site chamber (IV admin set)

Preparation

Draw up 500 units of Heparin into the small syringe and inject it into the empty 60cc syringe. Attach the IV set to the bag and attach the cuvette to the IV set.

Drain out 60cc of saline as waste, priming the tube and cuvette; make sure that the cuvette is held upright.

Close the roller clamp on the IV tube.

170cc of saline will be left in the bag as 60cc was discarded and 20cc is in the IV line.

Turn on the UBT device to warm up the bulbs. Check that all bulbs light.

Set up the patient

Swab the IV site with alcohol wipes; apply the tourniquet; enter the vein with the butterfly needle.

Tape down the butterfly when you are in the vein and see a flash of blood.

Clamp the butterfly line, remove the cap and attach the 60cc syringe.

Unclamp the butterfly line, draw 40cc of blood into the syringe, clamp the butterfly line, detach the 60cc syringe.

Attach the line from the cuvette to the butterfly needle line.

Place the cuvette in the already warmed-up device.

Open the roller clamp below the bag to allow some saline to flow and flush the line to the patient; close the roller clamp.

Treat the patient

Attach the 18G needle to the blood filled syringe and infuse the blood into the saline bag.

Gently mix the blood, Heparin and saline mix by massaging the bag for a few seconds.

Put the bag on an IV stand, open the roller clamp on the IV line and set the flow rate to 4 drops per second (10cc/minute).

Observe the patient to ensure that there is no swelling at the needle site during the 20-30 minute procedure.

Wrap-up

When the IV stops, lift the line to empty into the patient all of the blood/saline mix in the line. Clamp off the butterfly line before the end of the blood/saline mix reaches it.

Remove the butterfly needle; use a bandage to apply pressure to the puncture; dispose of the butterfly needle properly.

Finish patient care.

Note: The original protocol used in all the reported trials drew up to 250cc of whole blood (depending on body weight). All the trials prior to 1960 were done using Knott’s device which used a mercury lamp and a reusable forerunner of the cuvette. Knott’s device had ceased to be manufactured by 1960 and, as the ones in existence (or the doctors) wore out, a predecessor to the current device replaced them. That device used a disposable fused-quartz cuvette that tended to have laminar rather than turbulent flow. The UV light was not able to penetrate to a depth of more than a few cells before it was blocked by blood on the inside of the cuvette. The protocol above was developed since 2010. By diluting the blood and ensuring turbulent flow through the cuvette, all the blood gets exposed to the UV so only 40cc is needed. The Heparin prevents clotting anyway, but the risk of clotting is further reduced by dilution.