air bubble in syringe - page 2

by colleennurse

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Wondering if someone can help me out here. I was reading in one of my pediatric textbooks and for immunizations it says something about leaving an air bubble in the syringe (I know that you do this for lovenox too), but why,... Read More


  1. 0
    Man, this issue goes on and on.
    A syringe is made to give the correct dose that is marked with what is in the needle. If you think about it the plunger would stop and the needle would still be full. Therefore changing the needle is not a great idea and you would lose some.
    Lovenox has a bubble that is to follow in the injection to keep the solution in the sub-q tissue and prevent bruising.
    A bubble in a IM injection is also to keep the medication in the muscle and not the subq tissue. The bubble also needs to be behind the medication.
    One of my biggest irks is a nurse who doesn't give any insulin that is 2units or less because it isn't even enough to get through the syringe. They act as though it's an unwrittten law.
    As a diabetic I can tell you that those 2 units do get through and they do make a big difference for some. 2 units will drop my blood sugar 200 pts. So don't skip the insulin!
  2. 0
    Quote from sweetpooty
    Man, this issue goes on and on.
    As a diabetic I can tell you that those 2 units do get through and they do make a big difference for some. 2 units will drop my blood sugar 200 pts. So don't skip the insulin!
    WOW, thanks so much sweetpooty (I feel a little dirty writing that LOL). I have always heard that about insulin. It's great to hear that from a nurse AND a diabetic!
  3. 0
    the bubble in the lovenox syringe is actually a nitrogen bubble not an air bubble.
  4. 1
    I was told that, for adults, you'd have to give most of a set of an IV tubing full of air for it to actually hurt the patient. That's for a peripheral line, of course. I work with neonates who mostly have central lines, so of course we're practically psychotic about getting all the air out of the tubing, but is that true for adults?
    tokmom likes this.
  5. 1
    Quote from elizabells
    I was told that, for adults, you'd have to give most of a set of an IV tubing full of air for it to actually hurt the patient. That's for a peripheral line, of course. I work with neonates who mostly have central lines, so of course we're practically psychotic about getting all the air out of the tubing, but is that true for adults?
    Yes, you don't want air in a central line no matter what the age. I don't worry about air bubbles in periph lines either, especially when I give meds up the line, but too many pts freak out about it so I let them see me pull the air bubble out.
    tokmom likes this.
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    what is your recommendation for patients with hht (hereditary hemorrhagic telangiectasia) where arteries shunt directly with the veins? avm's (arterial venus malformations) form in patients with hht and there are no capillaries at these shunts, therefore air does not get filtered. when this occurs, the air bubble will go to the brain, causing a probability of stroke. in patients with normal blood vessels, this is not an issue and they can tolerate small air bubbles. however, patients with hht cannot tolerate and air bubbles.
  7. 0
    Glad I found a thread on this topic! I just did my first flu shot clinic yesterday, and left pretty confused about the issue of air bubbles for IM injections. We were using pre-filled syringes. Our instructor demonstrated putting the needle on, then pushing the air out before administering the injection. Once I got to my station, the RN supervising me there told me after I gave the first shot that removing the air bubble from the syringe is unnecessary, and actually undesirable because you lose a few drops of the dose when you push the air out, and the air helps keep the vaccine in the muscle. After that I left the air bubble in.

    Another point of contention: Whether or not to pinch up the deltoid with your non-dominant hand while administering the injection. Our instructor demonstrated giving the injection while pinching the muscle up. I found this helpful for visualizing the muscle to find the proper place to inject, but I don't see why you would hold it in that position for the injection? One of the nurses told another student that you would only do that on very small people, and that you might actually miss the muscle doing that on a larger person. Makes sense to me.
  8. 0
    We are going to using new syringes at my facility. They have a small airbubble at the top of them when filled. The guy said you could stand there all day knocking it out, but it won't budge. Once you push on the plunger it locks toward the end and the needle retracts into the syringe.
    Anyway, I thought of those new syringes with this thread.
  9. 1
    Quote from Little Panda RN
    Okay I am also confused. I was taught in nursing school that the air bubble in the lovenox was to keep the medication locked into the subq tissue to help prevent bruising. I have never heard of a bubble being injected into muscle. Maybe someone on this board could help to clarify this issue.
    Nice idea.....but about a week after getting home, Lovenox leaves someone looking like an eggplant.... Bubbles or not.
    tokmom likes this.


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