[corbin_SN]

Hi! Today in lab, we learned IV tubing. My professor was unclear about air in the tubings. She said that one needs to prime the tubing to get the air out, but she was unclear on whether or not all air pockets had to be removed. At one time she said that it is ideal to have the air pocket completely gone, but then she said that because it is not going into an artery, it is not crucial to remove all the air pockets completely. Any thoughts on this?
Thanks!
Daniel

[Daytonite]

Daniel. . .I was an IV therapist for many years and nationally certified in IV therapy. Sometimes it is almost impossible to get all the air bubbles out of IV tubing which is why your instructor was a little vague about this. Ideally, yes, you want to clear out all the bubbles. In reality, it doesn't always happen. There are all kinds of little nooks and crannies for them to get caught in. It takes more than a full 1cc air bubble to cause a problem in the human vascular system, so these little air bubbles that get stuck in IV tubings and might get infused into someone's vein are really nothing to worry about. They won't cause a problem. In actuality they are infusing into a vein where the blood is headed to the heart and the vessels they are traveling through are getting larger. The minute any air bubble hits the vena cava and gets into the right ventricle, the turbulence breaks the bubble up into much smaller bubbles and it becomes an insignificant threat. Air bubbles are more of a nuisance with regard to the IV pumps which will detect them as they run by the machine's air detector. And then, there is the occasional defectively manufactured IV tubing that has a miniscule air bubble in the plastic tubing itself which the IV pump is very good at detecting, but we can never seem to see with our naked eye and will drive you nuts trying to figure out why the pump keeps alarming.

We had a real active discussion some months ago on the forums about air that enters the circulation through periperal IVs and then air embolisms which are a complication of central IV catheters. Now, these are a concern when a central line that becomes accidentally open to atmospheric air due to the IV tubing becoming disconnected from the line or a cap of one of the ports comes off. What happens is when the patient takes a breath, by negative pressure created in the chest cavity (keep in mind that the tip of the central catheter generally rests in the vena cava of the heart), it causes atmospheric air to be pulled into the open end of the catheter and right into the vena cava of the heart! Very quickly that air bubble is moved into the ventricle of the heart. If there is more air than blood you got a whole heap of trouble on your hands--similar to vapor lock on a car. Here's the link if you're interested:

• http://allnurses.com/forums/f8/iv-ai...on-190642.html

[corbin_SN]

Wow, thanks! That helps so much. Thank you for taking the time to respond.
Daniel