UNPRIMED IV LINE (LINE FULL OF AIR) and STILL ALIVE!

[iheartcanucks2012]

So I was searching how much air could actually be fatal to a patient and some say an unprimed IV line could actually cause embolism.

I just had my baby a couple of months ago and during labor, they had to start an IV on me. I was in so much pain and couldnt really think straight. I have nothing against my RN coz she did her job so well, except for the fact that she forgot to prime the tube. (SHe's been a L&D nurse for 15+ years). I was on gas but I could vividly remember that incident. I thought she primed the tube already before running the line on @ maybe 150-200/hr, but when she opened the line I swear, I could feel bubbles coming in to my veins going up my left arm. Drugged and groggy as I was, I tried to reach for the roller clamp to slow it down but she confronted me and told me not to touch it!

At that point, I was already hoping for the worst, I was thinking I could go into an arrest anytime so I just tried to lay on my side. A few minutes later I was coughing, in my mind I thought, maybe this is it! Ima go into a cardiac arrest! The coughing continued for a good 5-10 mins maybe until the anesth came to put the epidural cath on.

Thank God nothing serious really happened. I was so scared for myself. I was told in nursing school never, EVER ever have an inch of air in the line. And I have frequently dealt with patients asking me to withdraw even a small dot of air in their IV tube. Sometimes I have to flick even the tiniest amount of air up to the chamber. Imagine my scare when an unprimed IV line was run on myself!

[Esme12, ASN, BSN, RN]

A few little "bubbles" on an adult aren't harmful an a peripheral IV. It takes a serious amount of air into a central line into the heart on an adult to cause cardiac arrest. When I worked cath lab a cardiologist accidentally injected about 3 cc of air right down the coronary. The patient had immediate chest pain and ST elevation that was feeling and resolved itself without intervention.

Emedicine quotes that more than 5mls per kg is needed to cause significant complications. (average adult 70 kg would be 350 cc of air) Although there have been anecdotal non verified that as little as 20 cc's (double the amount of air in an unprimed IV line) has been reported to cause some problems.

Large amounts (of between 100 to 300 mls) have allegedly been fatal. But are from cardiac procedure and injected in or near the heart. Medscape: Medscape Access requires registration but is free.

So those pesky little bubbles travelling down the tubing are probably not going to do any damage. But never-the-less, it would be wise to take steps to minimize the risk of larger amounts of air entering the system.

• Don't forget to prime the IV line! Sounds stupid, but it happens more often than you think.
  
• When hanging a new bag on an existing line, check to make sure the previous fluid hasn't run down the line leaving a large airspace.
  
• Do not place IV fluids down on the bed when transferring patients etc. Laying the drip chamber down on its side only encourages air to enter the tubing.
  
• Expel any air from syringes of IV antibiotics, analgesia etc that you are about to administer.
  
• And of course always check to make sure any drugs or fluids being injected into the line are compatible with the fluid. Incompatible fluids may crystallize or form a sediment that will cause similar problems
  
  It is not uncommon for someone to "feel" the IV begin to infuse as the IVF is room temperature 70 degrees, and your body is 98 degrees. On a peripheral IV the blood will back up in the tubing and will not run in if not primed. It is completely unnecessary to flick out every single chamber on a peripheral IV and I usually tell the patient there is no danger but if they insist I will. I am sorry, but, no miracle occurred ........ you were just drugged:hug:. Your greater danger in labor is an amniotic fluid emboli which can cause cardiac arrest and death.
  

Congratulations on your baby!!!!!

[Fiona59]

I remember being told it would take the entire line of air to cause problems. That's a lot of air.

[Enthused RN, BSN, RN]

Your greater danger in labor is an amniotic fluid emboli which can cause cardiac arrest and death.

Congratulations on your baby!!!!!

LOL ... I just want to tell you, Esme, that I appreciate how thorough your posts are ... and how I loved the last two lines in this particular post. You go from emboli leading to cardiac arrest and death ---> congrats on your baby!

[PMFB-RN, RN]

Naw, nothing to worry about. That little bit of air in an adult isn't going to hurt anything. I have seen lots of patient get a whole line of air and nothing happens. I once saw a patient inject himself with 20ml of air into his IV (he was crazy and high on meth at the time. He was threatening to kill himself in the cops tried to touch him) and nothing at all happend to him. I don't understand why you thought you were going to cardiac arrest? Are you a nurse?

[PMFB-RN, RN]

I remember being told it would take the entire line of air to cause problems. That's a lot of air.

*** By entire line do you mean a typical IV line? In that case it would take a lot more than that. I have seen dozens of people get a line full of air with no illeffects at all.