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maureen lawler
Peripheral IJ / EJ
These show up from time to time, particularly from the ES.  We get them out asap.  Question is this...suppose it is 1 or 1.5 inches long and placed in distal portion, patient sitting bolt upright, as you pull it the patient sneezes... any chance of embolus or am I worrying about the impossible?  I remember Lynn talking about the possibility of this happening with a periph.
lynncrni
There is a much greater

There is a much greater chance of air embolus any time the puncture site is at or above the level of the heart. Removing when the patient is sitting up could be the problem. Sneezing will change the intrathoracic venous pressure to force blood out rather than pull air into the chest. This puncture site and the tubing coming loose from the catheter and removing the catheter would pose the biggest risk of air emboli.  

 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

windstrings
I personally have never

I personally have never seen a peripheral IV pull air or blood.... its always postive pressure rather than negative.

You say its a short catheter implying its not central.

The only lines I have ever seen pull air are central lines where the tip is in the SVC.

This is the only place I can think of where the pressure is negative "outside the heart"  as the heart sucks or pulls blood into the right atrium.

All other areas are under the low venous pressure being "positive".

Every time I've started an IV in a jugular, blood tends to gush out if not held firmly.

I am going merely by my experience which starts at 1982 and I have never witnessed this problem in the field.

I suppose it could be possible if perfect conditions exist, but I've never witnessed the need for concern.

 

 

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