[JL123]

Hello, I hope someone can help me with this question. I am a nursing student and it's been bothering me for a long time. What happens to air that enters the blood stream through a peripheral IV? I understand how the air can become an embolism, but my question is related to the scientific or physiologic mechanism that happens in the body that prevents complications. I have seen many air bubbles enter through PIVs and the people are fine. I just wonder, what really happens to the bubbles once in the body?

*Does the air bubble get absorbed somehow in the body? If so, how? Or, how does the body get rid of the small bubbles?

I've read in other forums that the lungs filter the bubbles but I don't understand exactly how, since I thought the blood stays separate from actual air in the alveoli. And also, the bubble would have to pass the right heart before getting to the lungs.

I would appreciate any explanation! Thank you!

[Daytonite]

Those bubbles that you see in the IV tubings that enter the vein make their way to the chambers of the heart (remember that the veins carry blood heading back to the heart) where the turbulence causes them to break apart into even smaller bubbles. Those miniscule bubbles of air are too small to do any occlusion or occlusive damage in the body. They eventually get absorbed into the tissues of the body.

Now, having said that doesn't give nurses free rein to permit this to happen. Efforts should be taken to prevent air from getting into the IV line and the patient's vein. You should know the immediate first aid for a large amount of air that enters the blood stream: turn the patient onto their left side with the head of the bed elevated to trap the air bubble in the upper right atrium of the heart.

[JentheRN05]

Very good Daytonite! You impress me more and more after every response i see you post!

[KIDNEYSareLIFE]

So, how much air is " alarge amount of air?" Do I need to look at every tiny bubble and think I need to get it out, or only long stretches of air?

[maryloufu]

I have wondered this too- thanks for asking and also thanks to the responders.

[PurrRN]

Me too, me too! Being a new student, ANY air bubbles in IV lines freak me out. So how much is too much?

[loricatus]

I've been told that it would take a whole tube of air to see any adverse reactions. I would think that this may be the definition for a "whole lot of air" Please tell me if I am wrong.

[nananurse2]

Our IV instructer (RN for MANY years) told us it takes around 25 cc's of air to cause an embolism. Small bubbles still give me the willy's, but I take great care to prime the lines and flick bubbles out.

[CraigB-RN]

Wait till the first time you actualy intentionaly inject air bubbles for an ultrasound. In this care you make the bubbles smaller mechanically before you inject.

[RN007]

This article says:

"Small amounts of air do not produce symptoms because the air is broken up and absorbed from the circulation. Although classical teaching states that more than 5 mL/kg of air (IV) is required for significant injury (including shock and cardiac arrest), patient complications secondary to as little as 20 mL of air (the length of an unprimed IV infusion set) have been reported. Further, as little as 0.5 mL of air in the left anterior descending coronary artery has been shown to lead to ventricular fibrillation.

eMedicine - Venous Air Embolism : Article by Andrew G Wittenberg, MD, MPH

Hope everyone's having a great day!