Air in I.V. tubing

MelissaPhoographerRN · Mar 9, 2009

Is it on a pump or no??

The pumps we use we can back prime into a syringe or piggy back bag hooked to the pump.

If not you should be able to put the syringe on the port, pinch the line below the port, then pull back until the air is out.

Before hooking the line up you can get air out of the bag. But, this requires you to spike the bag and then unspike it. Spike the bag to open it up, then pull the tubing back out. Turn the bag upside down and push the fluid toward the hole until the air is out and respike. I've done this a few times, but usually not worth the trouble.

*ac* · Mar 9, 2009

I would like to know this, too.

annmariern · Mar 9, 2009

Hi, faster to disconnect and just run the air out before reconnecting. Little bubbles upsets the pumps, but remember it would take a significant amount of air to hurt your pt. Ranges vary in amount depending on cardiac/pulmonary issues, 50 - 100mls seems most people tolerate from what I've come across in , seems a lot. For me, any more than a smallish bubble bothers me and the pt, so flush it through and reconnect. For piggybacks, there always seems to be air and the pumps alarm. Holding the piggyback lower than the main fluids for a few seconds eliminates that, just add 2 mls more to the volume to be infused. Hope that helps?

*ac* · Mar 9, 2009

Hi, faster to disconnect and just run the air out before reconnecting. Little bubbles upsets the pumps, but remember it would take a significant amount of air to hurt your pt. Ranges vary in amount depending on cardiac/pulmonary issues, 50 - 100mls seems most people tolerate from what I've come across in , seems a lot. For me, any more than a smallish bubble bothers me and the pt, so flush it through and reconnect. For piggybacks, there always seems to be air and the pumps alarm. Holding the piggyback lower than the main fluids for a few seconds eliminates that, just add 2 mls more to the volume to be infused. Hope that helps?

What if running the air out also runs out a lot of fluid - and you don't want to lose it, such as with a blood transfusion. There is a way to pull the air out of the tubing with a syringe; I just don't remember exactly how to do it.

Bumashes, MSN, APRN, NP · Mar 9, 2009

If you don't want to disconnect or use a syringe and all the other suggestions, then here's another:

Depending on the tubing used, you can "twang" or slap the air up the tube and into the IVF bag. To twang, I mean to pull the tubing taught very quickly over and over in order to dislodge the bubble from the side of the tubing. Same with slapping or flicking the tubing. It causes the bubble to dislodge and float back up the tubing and into the drip chamber or IVF bag. Problem solved.

CABG patch kid, BSN, RN · Mar 9, 2009

If you want to pull it out with a syringe, just flick the tubing with your finger to get the air up to the nearest port (nearest to wherever the air bubble is). The port should "trap" it for a second. Then sterilize your port, hook up a 10cc syringe, pinch the tubing above the port and pull back on your syringe. That should get the air out.

Also, as far as taking all the air out of your IV bag when you first spike: Its not that important for regular infusing IVs but is very important to take out that air if you are running a pressurized bolus for rapid infusing in; you could give the patient an air embolism in that case.

The best way to prevent air bubbles when you first set up your new tubing is to hang your bag high, let the fluid fill the tubing as slowly as reasonable possible, and keep your tubing coiled up together rather than having kind of messy in your hands. Seems like when you take your time and keep things neat it comes out nicer.

Pediatric Critical Care Columnist · Mar 9, 2009

I prefer to push the bubble up into the buretrol or bag, rather than pull the bubble down. I fill a 10 or 20 mL syringe with the IV fluid using the injection port on the buretrol or the port between the bag and buretrol. Then I swab the port below the bubble, attach the syringe to the port and pinch the tubing below the port. Then I slowly push the fluid into the tubing, causing the bubble to rise up to the chamber on the buretrol. The trick is to do it slowly so you don't create any turbulance in there and make even more bubbles. Of course the tubing has to be removed from the pump and the slide clamp opened. If you don't want your patient to get a fluid bolus, make sure you've closed off the slide clamp closest to the site.

Thankful RN,BSN · Mar 9, 2009

Wouldn't it be easier if you asked a nurse at work to show you how? Never, be afraid to ask questions at work.

KyPinkRN · Mar 9, 2009

If you want to pull it out with a syringe, just flick the tubing with your finger to get the air up to the nearest port (nearest to wherever the air bubble is). The port should "trap" it for a second. Then sterilize your port, hook up a 10cc syringe, pinch the tubing above the port and pull back on your syringe. That should get the air out.
Also, as far as taking all the air out of your IV bag when you first spike: Its not that important for regular infusing IVs but is very important to take out that air if you are running a pressurized bolus for rapid infusing in; you could give the patient an air embolism in that case.
The best way to prevent air bubbles when you first set up your new tubing is to hang your bag high, let the fluid fill the tubing as slowly as reasonable possible, and keep your tubing coiled up together rather than having kind of messy in your hands. Seems like when you take your time and keep things neat it comes out nicer.

Also when priming your tubing for the first time keep the ports inverted (meaning point the connection site towards the floor.)... this prevents air from getting trapped in them.