air embolism

[c_looney2006]

I'm an emt intern right now doing my clinicals and I had to prep my first iv bag and I noticed some air moving down the line and into the pt via the iv cath. When I asked the medic about it he said that some air won't hurt and then he changed the subject. I'm not questioning his answer or practices at all just was woundering how the body gets rid of the air bubble..does it just breaks and down and attaches it to hemogloben and passes it out of the lungs?


Thanks

 

[Summit]

It takes quite a bit of air in the venous side for there to be a problem. Think about it in terms of A&P:

It goes into the venous side of the systemic circuit. It goes in a vein and then into progressively larger vasculature until it gets to the heart. If it hasn't gone entirely into solution by then (the O2 will go into solution and bind to the hemoglobin, the N2 will go into solution) it will hang out into the heart and go into solution. Rarely would it go into the pulmonary circuit. You'd need a lot of air to do that or you'd need a patient who was nitrogen saturated (like a SCUBA diver).

We worry about air getting into the arterial side of the cardiac circuit or the systemic circuit where we call it an... ARTERIAL GAS EMBOLISM.

This usually only happens if you have pulmonary trauma, particularly barotrauma... or if you have bubbles going into an arterial line.

 

[Shishkabob]

A little air won't hurt. We had a thread on this a while ago and I searched for info on it, and most sources cite you need between 5-20cc/kg of body weight to be any kind of real danger.

That's almost half an iv bag at minimum to be a danger, and there is no reason why you should miss that.

A tiny bubble in the iv line will typically not be a big deal, but it's always better to flush it out anyhow.

 

[c_looney2006]

Oh....okay...thanks....I was gonna bring it back up later but then we ran like 8 calls back to back and I just forgot about it til now and I'm doing my skill sheets about my shift for class...thanks!

 

[Summit]

I like MAST.

 

[redcrossemt]

I like MAST.

...as in MAST pants? or did I miss something?

 

[Lifeguards For Life]

I like MAST.

we dont have pasg's in our county

 

[c_looney2006]

Are u refering to MAST ambulance service?

 

[akflightmedic]

You have been given good information in the above postings.

Now it is your job to educate others so we get away from saying "just because" to explaining the real reasons why we do or do not do something.

Now, here is a little tip to ease your mind from the deadly bubbles.

Before you spike the bag, push the flow dial all the way to the top of the line so it is just below the drip chamber. Make sure it is clamped shut. Now spike the bag, fill the chamber half way and then unclamp the flow dial and move it slowly all the way to the other end.

You will not have any air in the line.

 

[c_looney2006]

Thanks for the tip on prepairing the bag...ill have to remeber that...we were never taught it in class or shown....I just had a general knowlege on how to do it.


Thanks!!