Air in IV lines/syringes

  1. I get so many various answers I'd thought I would throw it out here.

    How much air in a IV line is too much?

    I am so paranoid about air in lines and syringes. Reason being is that a few years back a coworker of my mom's died after she was injected with too much air from a syringe. A young mom that was in for a D&C to help concieve again. I know it had to be a big error and not just some little air bubble.
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    About kcochrane, ASN

    Joined: Jul '07; Posts: 1,517; Likes: 1,476
    RN, Nurse Manager; from US

    39 Comments

  3. by   klone
    A coworker of mine, who is kind of the Cliff Claven of healthcare, likes to share that the Nazis (Mengele) did research on this very topic, and they found that it takes nearly a whole IV line of air in the IV in order to cause death. The body is generally very good at breaking down the air. For me, if it's less than 1/2 -1" of air, I don't worry about it, I will just tap it to break it up a bit.

    I know that patients get very worried when they see the smallest air bubble in the line, so I reassure them that it's not like in the movies, where one tiny bubble is going to cause harm.
  4. by   klone
    Out of curiosity, I did a quick google and an article I read said that "as little as 20ml" can cause 'some problems'" (that is the amount of an unprimed IV line), and that between 100-300ml can be fatal. So that's the amount of 5-15 IV lines. That's a whole lot of air.
  5. by   teeniebert
    I don't have exact numbers, but when someone is having a 'bubble test' echo done, they get 20 or so mL of agitated saline (lots of air bubbles in it) injected and I've never heard of anyone dying from it. Incidentally, bubble tests are really fun to watch.
  6. by   kcochrane
    Thanks everyone. That helps alot.
  7. by   dskrninpa
    Our work Claven said that the whole line test was done on dogs. I asked a pulmonologist who said that sounded about right though. I still try to get all the bubbles I can out though.


    Quote from klone
    A coworker of mine, who is kind of the Cliff Claven of healthcare, likes to share that the Nazis (Mengele) did research on this very topic, and they found that it takes nearly a whole IV line of air in the IV in order to cause death. The body is generally very good at breaking down the air. For me, if it's less than 1/2 -1" of air, I don't worry about it, I will just tap it to break it up a bit.

    I know that patients get very worried when they see the smallest air bubble in the line, so I reassure them that it's not like in the movies, where one tiny bubble is going to cause harm.
  8. by   SweetOldWorld
    Quote from klone
    A coworker of mine, who is kind of the Cliff Claven of healthcare, likes to share that the Nazis (Mengele) did research on this very topic, and they found that it takes nearly a whole IV line of air in the IV in order to cause death.
    Think for a moment about what you have posted here. I am horrified that a professional nurse could casually post secondhand comments about Nazi "research" as if it had any legitimate meaning in practice. If such "research" was even done in the first place, that is.

    I would hope we could base our practice on legitimate, peer-reviewed research. Not garbage like this.
  9. by   RedCell
    Quote from teeniebert
    I don't have exact numbers, but when someone is having a 'bubble test' echo done, they get 20 or so mL of agitated saline (lots of air bubbles in it) injected and I've never heard of anyone dying from it. Incidentally, bubble tests are really fun to watch.
    I was going to mention that most people have no idea how much air gets into the right side of the heart until they have seen what the TEE can reveal. Basically, unless you have communication between the right and left atria or ventricles there is really very little to worry about. All that air in your line simply goes through the pulmonary arteries, diffuses through the alveoli and out through the pie hole.

    Sweetoldworld, don't be so fast to criticize your peers. Much of our advancements and current practice in medicine as well as nursing is based on discoveries made by the United States and others engaged in conflict with other nations (WAR). Nazis DEFINITELY included.
  10. by   CFitzRN
    Quote from RedCell
    I was going to mention that most people have no idea how much air gets into the right side of the heart until they have seen what the TEE can reveal. Basically, unless you have communication between the right and left atria or ventricles there is really very little to worry about. All that air in your line simply goes through the pulmonary arteries, diffuses through the alveoli and out through the pie hole.
    Ah yes, the pie hole. Such a technical term you chose to use.
  11. by   CFitzRN
    FWIW, our Pharm instructor told us that up to 40 ml was "safe" but I've read other research that indicates that there is no "safe" number. What causes seemingly no problems with one person may be enough to kill another. I think it's always the safest practice to get rid of air whenever we can.
  12. by   klone
    Quote from SweetOldWorld
    Think for a moment about what you have posted here. I am horrified that a professional nurse could casually post secondhand comments about Nazi "research" as if it had any legitimate meaning in practice. If such "research" was even done in the first place, that is.

    I would hope we could base our practice on legitimate, peer-reviewed research. Not garbage like this.
    I know exactly what I've posted here. I apologize if I sounded "casual". In no way was my intent to minimize the horrors that concentration camp victims experienced at the hands of the Nazis.

    It would be inaccurate, though, to deny the huge amounts of medical research done. There have been many books written about the subject.

    IMO, we do a disservice to the people who were sacrificed at Mengele's hands by discounting the knowledge that has been gained through the (horrible, yes) medical experiments they did.
  13. by   SweetOldWorld
    Quote from RedCell
    I was going to mention that most people have no idea how much air gets into the right side of the heart until they have seen what the TEE can reveal. Basically, unless you have communication between the right and left atria or ventricles there is really very little to worry about. All that air in your line simply goes through the pulmonary arteries, diffuses through the alveoli and out through the pie hole.

    Sweetoldworld, don't be so fast to criticize your peers. Much of our advancements and current practice in medicine as well as nursing is based on discoveries made by the United States and others engaged in conflict with other nations (WAR). Nazis DEFINITELY included.
    I see. Do you have links to the published studies for those? And the names of all those humans killed in the name of research?
  14. by   qt2168
    Sweet I do not know why your attacking the other poster about the nazis because the medical information they gathered (though it was in a horrible way) has been used today. Especially information about hypothermia. I know that it was not gotten the correct way but should we ignore information that might save others?

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