Air in Line: An Alarming Issue

BACKGROUND: The infusion of air from IV tubing can adversely affect the vascular system and potentially result in a venous air embolism. Infusion pumps are designed to alarm when air in the IV line (AIL) reaches a set threshold and can result in disruptions in drug delivery and decreased nursing productivity. Depending on the method employed, removal of AIL can also pose a risk to healthcare workers and patients. OBJECTIVES: This article discusses how AIL occurs, methods used for manual removal, devices currently available to reduce the occurrence, and new technology that may eliminate AIL. METHODS: In addition to a nonscoping literature review, authors conducted surveys of nursing attitudes about AIL at three nursing conferences. FINDINGS: Although the literature discusses the dangers associated with venous air embolisms in animal models and human case studies, little has been published on practical remedies for AIL. Surveys from 426 nurses revealed that AIL continues to be a ubiquitous problem, with the most common method for AIL removal involving disconnecting IV tubing or manual aspiration (77%). Clinicians have used back-check or antisiphon valves and air-eliminating filters with limited success. Companies are developing newer technology that does not require manual nursing intervention.