PIV air in tubing

  1. Hi-
    I am an RN student and witnessed some air go into a patient from the saline lock. As the nurse turned the pump on I noticed the air bubbles in the SL, but the nurse said it was inconsequential. I kept an eye on the patient closely for a while to make sure, but he had no signs of respiratory distress or other complications. Myself, I think I would have retrieved the air from the SL just to be sure. I was just wondering how much air it would take to cause a problem and if the symptoms would be immediate or if he could have had complications after my shift ended?
    Thank you
  2. Visit mesa14 profile page

    About mesa14

    Joined: Dec '07; Posts: 57; Likes: 7
    RN; from US
    Specialty: 3 year(s) of experience

    9 Comments

  3. by   mama_d
    She was right...it takes much more than the small amount you'll sometimes get in lines to cause problems. I'll look around and see if I can find a specific number. Many patients get freaked out by it, especially since tugging on the line when it's in the pump can cause bubbles, so it happens all the time. My pat answer to them is "It would take more than this whole tube of air to harm you."

    If it makes you feel any better, keep in mind that in TEE's we regularly inject the patient with about 5 cc's of air mixed with 5 cc's NS in one bubbly fast push.
  4. by   mesa14
    Thanks-
    The patient didn't even see it and I made sure to talk to the nurse without him knowing so that he didn't get freaked out. That makes me feel a lot better, its just that when u r a student u learn everything textbook style and I worry when I can't provide care in this "perfect world" manner.
    Thanks again
  5. by   CuriousMe
    Quote from mesa14
    Thanks-
    The patient didn't even see it and I made sure to talk to the nurse without him knowing so that he didn't get freaked out. That makes me feel a lot better, its just that when u r a student u learn everything textbook style and I worry when I can't provide care in this "perfect world" manner.
    Thanks again
    I can't remember the number our instructor gave us when we were learning about IV's in lab......but we worked it out and it would have to be a large portion of the primary line to cause trouble.

    Of course we should always try to get rid of any big bubbles we see....but the take home message was that if a few small bubbles get by, it will be fine.
  6. by   Daytonite
    mesa14. . .let me set your mind at ease. it takes well over 1cc of air to do anyone damage. 1cc of air is a lot of air. as an iv therapist i saw a lot of nurses get all kinds of air bubbles in iv tubings and never had a patient suffer any ill misfortune as a result. just a lot of sloppy nursing technique.

    there is a previous thread about this: IV air bubble compensation. while it is always good practice to try not to get air bubbles into iv lines and saline locks, it does happen and small ones will not hurt the patient. the blood in the veins makes its way to ever enlarging vessels which end at the right vena cava of the heart. the turbulence in the right vena cava breaks apart the air bubbles so they get even smaller than the size they started out. the first place an air bubble is going to get trapped is in the pulmonary network. however, after being shaken up in the right atrium and right ventricle a small bubble really is reduced to something smaller than a rbc.

    in the thread above, i believe we talked about air embolism, a complication of central lines. air bubbles of significant amounts get sucked into the right vena cava though an accidentally opened central iv port and that air bubble has to be isolated in the apex of the right ventricle stat or the patient will be a goner. that is done by turned the patient onto their left side and placing them in reverse trendelenburg (head down). remember air floats up and that is exactly where we want that air bubble to "float" to the highest point of the heart which will now be the apex of the right ventricle (with the patient on the left side, head down).
  7. by   mesa14
    Thanks everyone, I feel better
  8. by   *ac*
    Quote from daytonite
    mesa14. . .let me set your mind at ease. it takes well over 1cc of air to do anyone damage. 1cc of air is a lot of air. as an iv therapist i saw a lot of nurses get all kinds of air bubbles in iv tubings and never had a patient suffer any ill misfortune as a result. just a lot of sloppy nursing technique.

    there is a previous thread about this: IV air bubble compensation. while it is always good practice to try not to get air bubbles into iv lines and saline locks, it does happen and small ones will not hurt the patient. the blood in the veins makes its way to ever enlarging vessels which end at the right vena cava of the heart. the turbulence in the right vena cava breaks apart the air bubbles so they get even smaller than the size they started out. the first place an air bubble is going to get trapped is in the pulmonary network. however, after being shaken up in the right atrium and right ventricle a small bubble really is reduced to something smaller than a rbc.

    in the thread above, i believe we talked about air embolism, a complication of central lines. air bubbles of significant amounts get sucked into the right vena cava though an accidentally opened central iv port and that air bubble has to be isolated in the apex of the right ventricle stat or the patient will be a goner. that is done by turned the patient onto their left side and placing them in reverse trendelenburg (head down). remember air floats up and that is exactly where we want that air bubble to "float" to the highest point of the heart which will now be the apex of the right ventricle (with the patient on the left side, head down).
    daytonite, in the previous thread you referenced, you said the pt should be placed with the hob elevated, and that the goal was to float the air bubble to the atrium.
  9. by   Daytonite
    Quote from *ac*
    Daytonite, in the previous thread you referenced, you said the pt should be placed with the hob elevated, and that the goal was to float the air bubble to the atrium.
    Are you talking about the Air Bubble Compensation thread? That was a few years ago! I don't remember what I wrote then. I am sure someone corrected me. It was either a typo or a mistake. I keep the link to the thread in a file because the question about air bubbles gets asked occasionally, so I post it.
  10. by   beth66335
    Yes, the correction is in post #14
  11. by   madnurse2b
    Quote from daytonite
    mesa14. . .let me set your mind at ease. it takes well over 1cc of air to do anyone damage. 1cc of air is a lot of air. as an iv therapist i saw a lot of nurses get all kinds of air bubbles in iv tubings and never had a patient suffer any ill misfortune as a result. just a lot of sloppy nursing technique.

    there is a previous thread about this: IV air bubble compensation. while it is always good practice to try not to get air bubbles into iv lines and saline locks, it does happen and small ones will not hurt the patient. the blood in the veins makes its way to ever enlarging vessels which end at the right vena cava of the heart. the turbulence in the right vena cava breaks apart the air bubbles so they get even smaller than the size they started out. the first place an air bubble is going to get trapped is in the pulmonary network. however, after being shaken up in the right atrium and right ventricle a small bubble really is reduced to something smaller than a rbc.

    in the thread above, i believe we talked about air embolism, a complication of central lines. air bubbles of significant amounts get sucked into the right vena cava though an accidentally opened central iv port and that air bubble has to be isolated in the apex of the right ventricle stat or the patient will be a goner. that is done by turned the patient onto their left side and placing them in reverse trendelenburg (head down). remember air floats up and that is exactly where we want that air bubble to "float" to the highest point of the heart which will now be the apex of the right ventricle (with the patient on the left side, head down).
    thank you - i struggled at first with getting every itsy bitsy little air bubble out before hooking someone up. my instructor kept trying to get me to understand the amount was waay more. that explanation helped very much - thanks.

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