Air in IV lines

  1. Hey all!!

    I'm a new nurse and have a couple questions about IV lines. I saw an MD say that a correctly administered IV line should not have even the tiniest airbubble in it. I wonder if he's ever set up an IV himself.
    Anyway, my question is, when I hang a new bag of fluid or something, sometimes the pump says "air in line" and beeps and I have to fix it. I'm wondering if there's something that I'm doing wrong when I spike the new bag. Also, when I give IV pushes, there is sometimes air bubbles that I see. I'm wondering if this is just an occurence that can happen every time you access a port along the IV line that communicates with the outside. I was just wondering if anyone had any pointers. Thanks.
  2. Visit zacarias profile page

    About zacarias

    Joined: Oct '01; Posts: 1,352; Likes: 83
    RN; from US
    Specialty: 14 year(s) of experience in tele, stepdown/PCU, med/surg


  3. by   petiteflower
    Sometimes when you push a med there is a tiny amount of air that is collected in the port of the iv line. If you are concerned about this what you can do is draw back a little fluid from the line to clear the air and then administer the drug (kind of like you do with an IM injection).

    Also, when you change your IV solution bags, make sure that the tubing is primed above the pump. Sometimes it also helps--I don't know why, to hold the bag upside down when spiking it.
  4. by   RNmomma
    I think it is pretty common to have a few air bubbles in the lines. Very difficult to make sure there is absolutely no air, and probably a big waste of time. I have heard that there would have to be a very large bubble (like the whole line) to cause any problems to the patient. The "air in the line" beeps can be very frustrating! I think the trick is to get the line nicely primed, and not to let the bag run dry before hanging a new one.
  5. by   eak16
    I have always heard from nurses that it would take air in nearly the whole length of the tubing (20cc's?) to cause serious complications. Most nurses I know dont bother to take the air out by syringe if the bubble is less than an inch.
  6. by   melbnurse
    Aha ! at last ! something I might be able to help with ! Isn't it the pits, when you have hung the bag , set the rate ect , and triumphantly " hit " the switch, .....hold breath, and " beep beep"

    We have inserted a simple cup hook on the end of the cupboard where we prepare flasks , and before priming the line , ensure that the clip is closed directly under the drip chamber, before ypu spike the bag.
    Fill the drip chamber , BEFORE priming the rest of the line . Also LEAVE the guard on the bit that goes in the pump, til the line is primed . Has worked a treat for us

    This may be of help
  7. by   bellehill
    I have also found that when tubing is a day or two old it can get "worn out" and the pump thinks it is seeing air when really it is seeing kinked, used IV tubing. Try reinserting the tubing a little further down or up the line.
  8. by   sjoe
    Myths from fearful people notwithstanding, a small amount of air does NO harm. Just because this has been used as part of the plot in more than one murder movie, doesn't mean it is true, folks. ("Step on a crack...." etc.)
  9. by   Spidey's mom
    When I was in nursing school we had one very intelligent and precise teacher who taught very well. We all admired her. She addressed this issue by saying you should always remove the air from the line because who's to say yours has been the only bubble all day? How do you know the nurse before you didn't let go a few little bubbles of air? She was a real stickler for no shortcuts, because shortcuts come back to bite you in the tush.

    I find that when I turn the IV bag upside down to spike it, that is when bubbles get into the line. We also have a hook in our med room to hang the bags on and use the same procedure described by melbnurse. Then if you do find bubbles, all you have to do to clear the bubbles is use a syringe at a port lower than the bubble and suck it out. Simple.

    I've never forgotten her advice to remember the patient may have accumulated many bubbles in the veins by the time you let one slip by. Since it is so easy to fix, I just fix it.

  10. by   SmilingBluEyes
    yep invert the bottle to spike it.....
    "burp" it and voila

    no bubbles in your line.

    yes this works.
  11. by   pmchap
    All interesting thoughts, the hook thing is good - what I have found that works well is to spike the bag upside down, half fill the chamber by squeezing the bag, clamp the line then hang the correst way. Open the line and the line should prime without any air left, except those lovely little ports. The ports can be cleared of air during priming by turning the line while priming so that the port is pointing upwards and giving it a flick as fluid reaches it, remember that air will rise so and small air bubbles should flow along with the priming.

    Air associated with iv pushes can either be from the port site or form as a residual of mixing the iv medication, to fix, prime the port as described above and ensure that any iv meds are completely dissovled prior to giving.

    A little air may not hurt - but wouldn't we all feel a goose if by some off chance that little tiny bubble resulted in an emboli in the brain....
  12. by   Neon8
    Another little trick is when spiking a new bag (assuming the line hasn't run dry) is to crink the line with the hand you are going to spike with, spike the upside-down bag, turn the bag upright, half-fill the drip chamber, then let go of the crink.
  13. by   sjoe
    "wouldn't we all feel a goose if by some off chance that little tiny bubble resulted in an emboli in the brain"

    Since I have never seen an account of this having happened anywhere in the world at any time, nor of any research supporting the notion, I'll continue to categorize this notion with other myths and fantasies.

    (There are few geese in any healthcare facility I have seen for one to feel--but perhaps things are different "down under.")
  14. by   RNmomma
    I found this on the web by a Steven Harris, MD. And of course, it's on the web, so it must be true!:

    ////There is really no reason at all for a correctly performed intravenous injection to contain even a tiny air bubble.

    Nevertheless, a few cc's of air in your venous system (a standard IV line) would be harmless, unless you were unlucky enough to have a congenital atrial or ventricular septal defect, allowing bubbles to bypass the lungs. Lungs are a great filter, and they trap bubbles and clots before they get to the brain or other places where they do damage by interfering with blood supply.
    Failing a heart defect, the amount of air necessary to kill a normal person varies a great deal depending on position, chance, rapidity of injection, etc. It's more than several hundred cc's. Generally, you need enough to create a giant bubble in the right heart, large enough to interfere with liquid pumping ("vapor lock").

    A few patients have probably seen a little bubble go down their IV line and into them, and had heart attacks waiting for the heart attack!