I have recently been asked by the MERT team about the incidence of air embolus with PICC lines as they are reporting that they responded to 2 recent episodes with pt's whoses s/s are being attributed to just that. I have not talked in detail with the person to figure out how the came up with this deduction. I cannot imagine how an air embolus could happen unless the positve pressure valve fell off and the line was not clamped combined with alot of movement from the pt. Does anyone have any experience with this matter?
I am sure everyone is paying closer attention since treatment for air emboli is no longer reimbursable. It can happen as you said when the needleless connector or tubing comes apart from the hub. It has always been considered a theorectical possibility for it to happen when the catheter is being removed - skin to vein tract stays open and is connected to a tissue-like capsule that has formed around the catheter composed of fibrin, thrombus, smooth muscle and collargen. Upon removal it the site was not adequately sealed with an ointment-based gauze dressing, then air was pulled in when the patient sat up, stood up, and took a breath. It has never been reported to happen that I know of, but we have always known that it was possible. That is why the ointment is used on insertion sites at removal and why the patient should remain in bed for a while, although there is no firm guideline on the length of time.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861