Air Embolism

Did the patient have a peripheral IV or a central line. Patient's with CVL's and open-ended PICCs can get air emboli if the cap on the end (for example the CLC2000 that we use) gets loose and comes off. I've always understood that it's very difficult for someone to get an air embolism from a PIV. Someone would have to be pushing a syringe of air in, or so it seems.

It takes a LOT of air to cause death. 50cc or more. The only ones I have heard of involved misuse of blood salvaging equipment. I think you have a right to ask for more details. Without knowing how it was done and how to prevent it, it is only a scary story.

Nellie,

Small amounts of air in IV tubing usually is inconsequential, however, there has been reports of pts dying, especially if they are elderly and infirmed, with as little as 7 cc of air.

As far as a peripheral IV is concerned, a patient can suffer from an air embolism if he or she is flailing their arms around creating negative pressure when they have an open connection, but it is more likely to occur with a centrally placed catheter. It is important to make sure all connections are leur-locked, not slip locked.

Hope that helped.

For a patient to die of an air embolism only it would have to be a bolus large enought to block the pulmonary artery. On the other hand it could cause other symptoms with a smaller bolus. Usually the smaller boluses get trapped in the lungs. It would be very rare that PIV couls cause air embolism as the flow would most likely cause the blood to exit from the catheter and not draw air in.

Randy

I had a patient who developed a 150 pulse minutes after another nurse removed a RIJ catheter from her while sitting upright. Does anyone have experiences like this?

http://everything2.com/index.pl?node_id=930159

I just found the above and thought it, well... quaint.

Anyway, as far as I know, it takes a tremendous amount of air rapidly injected via periph IV if one wanted to use that as a way of killing someone. Not a very effective means. BTW, oral-lady partsl sex may give pregnant women deadly air emboli, because of the presence of the placenta.

Ralph

Also take a look at the allnurses air_embolism_iv_therapy thread: https://allnurses.com/forums/f27/air-embolism-iv-therapy-96687.html, it has a references that explicitly talks about how much is too much air, and mechanisms of complications.

I would ask for more details. In order to learn how to prevent this in the future your staff need to know exactly what went wrong. Here is my experience. It is very rare to get a fatal air embolism from a peripheral line especially now with the air alarms on all pumps. Was this an older model pump or one that an air alarm was bypassed. Usually an air embolism occurs from a disconnected central line or one that is not properly removed. There is a difference between atmospheric pressure and chest pressure allowing air to be sucked into the vein. So what do you do......Prevention is the best...use only leur loc connections and caps.......check all connections at start of shift and prn (anything can come loose)....investigate and leaks on the extension legs of any CVC......instruct pt on how to ambulate with pumps.....or go with them....never bypass or shut off air alarms on your pumps.....respond to call lights promptly......know what to do if you discover a disconnected line and pt is symptomatic....place pt on left side with head down in trendelenburg..someone contact MD..stay with pt...o2 keep an IV open

hi, i was just wondering...if the drip chamber of peripheral line gets too full and you turn the bag upside down and squeeze the drip chamber to force some of the fluid back down into the bag but you forget to close the roller clamp?? is this dangerous?? can the patient have vae?? please help[color=#ffffff]tto o [color=#ffffff]to force some of the fluid back down into the bag[color=#ffffff]force some of the fluid back down into the bag