alaris pump: air-in-line alarm. what's your method of removing air bubbles?

[seks]

Just curious how you guys do it?

I was watching this video

I do understand the need to use a syringe and attach the syringe to the lower port to aspirate that air (which is a huge amount). But after that, the people in the video mentioned that those little bubbles that they started pointing to aren't problematic to patients.

[LaughingRN]

We use alaris pumps, after having the pump beep multiple times for "air in the line" with no visible air...I decided to try a new approach. Open the pump where you feed the line and you will see two circle glass windows that are actually sensors...take an alcohol wipe and clean the windows...

98% of the time the problem is solved...dirty sensors equal not working sensors!

Trust me and try it:)

[TiffyRN, BSN, PhD]

Oh LaughingRN, I will have to try your alcohol swab trick.

We have horrible problems with "air-in-line" alarm on our Alaris pumps. And we can usually visualize a small bubble. In our environment (NICU), we are encouraged to minimize all breaks in the IV line, so we would look down on the method described by the video whereby one would break the line 2-3 times to aspirate air. Usually, our air-in-line in immediately below the infusion chamber and we will flick the heck out of it to get the air to float back to the drip chamber. If we have let the tubing run dry (we are only allowed to put 2 hours IV fluid in our burretrols at a time), we will clamp to the baby, attach a syringe below the air bubble and re-prime into the syringe. It's a real pain.

Another trick (it may be old wives tale) is to maximize the distance from the drip chamber to the IV pump. Our drip chambers often hand at or below the IV pump as we have the extra length from a burretrol set (they say these are going away soon, yeah!). I will often extend the IV pole as high up as it will go to maximize the distance, the theory being this allows those air bubbles to naturally ascend up to the drip chamber.

I discussed their frustrating pumps with an Alaris rep once. They said I shouldn't have to put that much distance between the drip chamber and the pump (ok, whatever, it seems to work) and that it's probably because our nurse manager required that the highest possible sensitivity be used for our air bubbles. The sensitivity issue makes sense, whereas adults can handle the small bubbles demonstrated on the video, a 600 gram micro-preemie cannot. I am amused how the rep explained how of course it wasn't the pump's fault.

[Sun0408, ASN, RN]

We also use the Alaris pumps and they can be a pain. I stretch the tubing when I prime it especially the area that goes in to pump.. I have found air trapped in there and the stretching allows for the fluid to push it out. Rarely do I have "air in line" anymore.

[redhead_NURSE98!, ADN, BSN]

The rep came and did an inservice recently, and said slow priming helps with the air problem.

[Dr Ram Kumar]

I am Dr Ram Kumar. I have been seeing nurses not working with infusion pump for the same reason. And Dear nurses I tried and suggested the following and most worked at one or other times:

1) clean the sensors inside even if there is no dirt. I don't know why but it works often.

2) Increase the distance from drip chamber to the pump and I make like U, so air goes up

3) Tapping method

But sometimes, it is very hard to get rid of them. I would love to know any other methods u use.

I have seen how the tubing gets folded and thinned inside.

[Dr Ram Kumar]

Can you make kindly a video of what u said. Thanks. Please mail or post in YouTube. Dr Ram

[Buckeye.nurse]

We seem to have the most problems with "air in line" alarms with our EPOCH infusions. As it is chemo, we do everything humanly possibly to avoid breaking the line. The alcohol trick that LaughingRN mentioned is great. We also put our IV poles as high as the door jams allow (like TiffyRN said, it might be an old wive's tale, but it seems to work). We've also tried paper taping the tubing down the side of the pole so that it is in a straight line from the drip chamber to the pump, putting the pump lower on the IV pole so that it is at the level of the heart, and ensuring the drip chamber is > 2/3 full to minimize agitation as the new drips enter the chamber from the bag.