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Discussion

Unprimed IV flush

I have a question about starting IV's. I work in a hospital and some student nurses were practicing starting IV's on each other. Apparently one of the students made a mistake because their instructor was pissed when she returned. From what I understood the student did not "prime" the flush after she inserted the IV and so injected air into the other student's arm? They said that it was good that she was not actually in the student's vein because that could cause big problems. But now I'm wondering what happens to the air in the student's arm? Will it just slowly be absorbed? I saw her the next day and she was sporting a nice blue bruise all over the crease of her arm.

Thanks for any information!

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From my understanding it didn't even go into her vein, just the tissue of her arm. I suppose it would just absorb over time?

The volume of air in many extension sets that are to be attached to the IV catheter is a fraction of a ml. (not 2-3 mls) Many PICC's hold 1 to 1.25 mls. Micro bore sets hold even less.

The volume of air in many extension sets that are to be attached to the IV catheter is a fraction of a ml. (not 2-3 mls) Many PICC's hold 1 to 1.25 mls. Micro bore sets hold even less.

Our j-loops are even less, only hold 0.5mL. Out of curiosity I measured it one day when I was priming.

Ok cool. Haven't measured. Same difference. Either way, no problem

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From what I understood the student did not "prime" the flush after she inserted the IV and so injected air into the other student's arm?

You prime the tubing BEFORE you start the IV.

And air will simply reabsorb and go away if injected into skin/muscle.

And yes, it is not good practice to insert air into veins but as others have said, it is probably going to be ok as it is a small amount. Regardless, don't do it.

Many people are scared of air emboli traveling to the heart. The volume of air in a j-loop is like 2-3 mL. I get it, it's bad practice and you shouldn't do it, but it's such a small amount it won't kill anyone. Check out this article for more info.

Volume of Air in a Lethal Venous Air Embolism | Anesthesiology | ASA Publications

Interesting article...long read to find out 200mls of air, forcefully injected is considered the minimum amount to be lethal in am average adult.

In response to OP's question.... yes, the air would just be absorbed into the tissue surrounding it.

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