Again... air bubbles in CVC

IVRUS, BSN, RN · Mar 8, 2011

I tried to find some answers for this problem but I am still not clear: what do I do when I find air in the central line (open-ended)? Do I aspirate the air plus blood into the syringe, discard syringe and use another one to flush? Could anyone clarify, please?

Are you asking what you should do if a central line is found with its cap off and the lumen is left OTA and is unclamped?

Yes, I would take a syringe and attempt to aspirate, removing air and blood too, but first, of course, stop the source of the air and also assess that pt. If my pt isn't suffering obvious ill effects from this issue, and I have a syringe on the open lumen, withdraw and discard the syringe after you withdraw and then reattach a syringe filled with NSS and flush. If you cannot withdraw any blood due to the catheter lumen occlusion, from blood which has clotted the catheter's lumen, place a new leur-lock injection cap on the catheter's end and proceed to obtain CATHFLO orders to lyse the occlusion. If your pt is symptomatic, follow emergency protocals for your place of employment.

creo · Mar 8, 2011

Thank you for the answer. I should have been more specific. My question pertains to the flushing of the lumen with cap on, clamp on but with air in the lumen.

IVRUS, BSN, RN · Mar 8, 2011

Thank you for the answer. I should have been more specific. My question pertains to the flushing of the lumen with cap on, clamp on but with air in the lumen.

Okay, But how do you know that there is air in the line?

creo · Mar 9, 2011

Because you can see air bubbles in the part of the lumen that is above the skin, the part that is visible when you flush the line.

IVRUS, BSN, RN · Mar 9, 2011

Well, if you are seeing air in the lumen, first make sure that there aren't any cracks in the catheter, or that lumen and then make sure you have a well-fitting leur-lock injection cap on its end to prevent this occurance.

After the above was assessed and no issues noted, take a syringe and do not flush, but rather withdraw approx 3mls of blood, discard that syringe and using another ten cc syringe, flush well with saline and if needed, heparin flush solution.

creo · Mar 13, 2011

Thank you!!