Air embolism from PICC line

[ivstarterRN]

Can you get an air embolism from a picc line? The scenario was that, a patient has a PICC line that was half way out of her/his arm, while she took a nap in the afternoon. One of the caps/ports were taken out by accident as well and was unaware of it. So one line in the PICC line had no port/cap on it and was just open to air for about 6 hours..Can a pt still develop air embolism from that? and how? please explain in detail...

[tmhop]

The patient could develop air embolism if air entered the catheter. The other possibility is that blood could come out of the catheter that was open.

It depends on the differences in pressure, as to whether air would go in, or blood would flow out.

[IVRUS, BSN, RN]

Can you get an air embolism from a picc line? The scenario was that, a patient has a PICC line that was half way out of her/his arm, while she took a nap in the afternoon. One of the caps/ports were taken out by accident as well and was unaware of it. So one line in the PICC line had no port/cap on it and was just open to air for about 6 hours..Can a pt still develop air embolism from that? and how? please explain in detail...

IVstartRN,

There are different types of IV catheters, and different types of PICC lines. If your patient has a valved IV catheter, like a Groshong PICC in place, unless the valve of the catheter is malfunctioning, there will be NO cause to worry about an air embolism or blood loss. However, you still need to be concerned with infection issues as microbes can enter a catheter that doesn't have a protective injection cap on its end. On the other hand, if your patient has a non-valved, or open-ended PICC, then YES, you should worry about air embolim, blood loss and infection issues.

These are reasons that it is imperative that the nurse who is caring for the line not remove the injection cap along with the flush syringe. Negative pressure from a person flailing their arms about can cause air to be sucked into the IV Line. In this case, if the patient was sedate, the line probably became occluded from blood backing up into it and if this occurred, it needs to have a fibrinolytic instilled to declot it.

[classicdame, MSN, EdD]

if blood was coming out then air could go in, but generally a filter prevents both.

embolisms with PICC's are more likely to occur from a flush or IV push with air in the syringe.

If the line was new, the embolism could be a result of insertion. Not necessarily improper insertion, but perhaps due to patient's coag state.

Could be an embolism was due to patient's condition, lack of mobility, all sorts of things are possible.