getting rid of an air bubble in an IV line

Nurses Safety

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How do you get rid of an air bubble in an IV line?

I appreciate your attention to details. After being a nurse for as long as I have, you do learn not to sweat the smallest stuff. Here are a few hints for you:

1. The best method to remove air from an IV line is one where the line is not disconnected from the patient- period. Why? Remember that one of the BIGGEST causes of hospital morbility and mortaility is blood stream infections (BSI). While BSI is referrring to central lines, any IV is access to a patient's blood stream.

2. One of the greatest causes of BSI is breaking the line connected to the patient. The less we disconnect a line (for air removal or to pass through a gown), the less we introduce pathogens into our lines.

3. A line should never be reprimed over a garbage can- period. Bugs fly.

4. The best method is to place a syringe distal to an air bubble while crimping the tubing just below the syringe (of course after cleaning the y-site with your institution's disinfectant of choice, ex CHG). Aspirate slowly and your bubble will be pulled up. If you have pulled med out of the tubing and don't want to waste, reinstill it with another sterile needle into the buretrol or bag.

5. One bubble will not hurt your patient- unless you are dealing with some cardiac patients with defects that will not tolerate any air- this is the peds nurse talking here.

6. Also remember that some medications should not be interrupted- inotropes and pressors- or you will have bigger problems than an air bubble!!

Sorry to sound like a Nazi here. BSI is one of my major responsibilites in my unit. :nurse:

Does this work if the air is below the pump? Do you have to take the tubing out of the pump (so it won't be clamped by the pump)?

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3. A line should never be reprimed over a garbage can- period. Bugs fly.

I'll ask you as I asked several previous posters--do you have any research or evidence to support this assertion? I would be interested in seeing the science that backs it up.

Thanks.

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Specializes in peds critical care, peds GI, peds ED.

Absolutely. If you reference the IHI website (the national group who sponsored the 100K lives campaign and were the first to shine the spotlight on BSI), the evidence for all the BSI guidelines and practice protocols are listed. Also, the American Journal of Critical Care Nursing has done fantastic research on "risky behaviors" that influence BSI rates.

I know each institution has their own policies and procedures. Believe me, the first question I ask when a current nursing practice changes is "where is the evidence?"

Let us know the information you find out. The better informed we all are the better care our patients will receive.:nurse:

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Specializes in CTICU, Interventional Cardiology, CCU.

when I was in nursing school at the 10000 hospitals I had clinical, one hosp. had a pump that would back prime to pull the air up into the chamber, which was GREAT.

But the hosp. I work in now as an RN, has the crap Baxter Pumps thathave one function, to dive you crazy! What I do is either take the line tap it and see if the air bubbels flow upward, or I just re-prime the tubing. BUT I have also, just kiked the tubing taken about 5-7cc's put and problem solved.

But when all else fails just re-prime trying not to waste a ton of fluid, if it's NS 0.9/0.45,D5 1/2 NS, I always just reprime. If it's a small dose IVPB or a 50-100 cc bag IV I try my best not to waste if I have to re-prime, or i flick the heck out of the line till the air dissolves

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