Question about air in the blood

[sandman]

My question concerns air in a syringe or in hemo dialysis lines.  When I go to my doctors office and a nurse gives me an injection, they overdraw some medication, then hold the syringe up-right and tap on it to get the air to the top and then push all the air out through the needle.  Now, I have seen a few nurses at Angie's clinic hook up a few patients, including Angie and I noticed that the nurses are not as concerned with removing all the air from the lines as they are from any syringes.
 
I have learned that introducing air into a persons arteries can be very dangerous, even lethal, which would seem to go along with why the nurses try to remove as much air as possible from the syringes.  So if this is true, (air in your vascular system being dangerous) then why is a little bit of air allowed during an HD connection?
 
Also, what happens to that little bit of air that is introdused into someones system?  Angie's nurse told me once that a tiny air bubble here and there is acceptable.  Reason I am asking this is because HD patients can have an air bubble or two get into their systems, three times a week.  Does the body eventually rid it self of that air or can it accumulate over time?  How much air is to much?

[kitkatz]

Air that is in the artery line is pushed through the machine and gets cleared out.  There is usually enough saline in the lines when they hook up the venous line that there is no air in it.

[brenda]

The diameter of you lines on the inside are a lot smaller than they appear. I would take feet of air in your lines to harm you. You body eventually absorbs the extra air. That was was what I was taught in home training anyway.

[angieskidney]

Ya my nurse told my brother 1 1/2 yrs ago who was worried about air in my IV that the body can handle up to 10 cc's? Is that right?

[sandman]

Reason why I am asking is because I was watching this old HD video and from what I can see, this guy never cleared the air from the needle lines.

http://www.youtube.com/watch?v=IatQ_RgYcww

So how important is it to remove as much air as possible from those HD lines?  What can happen if you get air into your circulatory system?

[Rerun]

I still can't watch!  Ahhhhhhhh

Like Kit Katz said, the blood flows out of the body and there is an air chamber in the tubing that traps the air.  If the air chamber gets too full of blood where it can't detect air it will alarm.  Have Angie point out the air chamber the next time you are with her on dialysis.

[renal30yrs]

I don't how true this is but I heard they use to use air (not saline) to push blood back in the patient's system in certain countries.  Its too hairraising to be real.  Probablly a dialysis urban legend.

[angieskidney]

I don't how true this is but I heard they use to use air (not saline) to push blood back in the patient's system in certain countries.  Its too hairraising to be real.  Probablly a dialysis urban legend.

Eeeek hope not! MUST be a legend! I am sure Epoman can find out on that site (I forget but it is post in IHD's off topic links thread somewhere) he likes for that stuff! lol

I think Sandman was wondering more about how they flush the fistula lines with saline before hooking up to the machine. And in that vid that was never shown. And then him and I got into a discussion about how the body can handle a certain amount

[billable]

When you see someone being extra careful drawing up a syringe full of a medication, they aren't as concerned about getting air into you as they are about getting the proper amount of medication.  One good size bubble of air can mean you are off as much as 0.2cc.

[BigSky]

I don't how true this is but I heard they use to use air (not saline) to push blood back in the patient's system in certain countries.  Its too hairraising to be real.  Probablly a dialysis urban legend.

Actually it was done in the US.  When I was on dialysis the first time in the late eighties they used air to push back the blood and a nurse would sit there with a clamp to clamp it off.

Air can be dangerous when injected.  It was touched on in this thread.

http://ihatedialysis.com/forum/index.php?topic=2159.msg30304#msg30304


What I had found about air being injected into the body and posted in that thread.

A single bubble isn’t going to do the trick.
Let’s review the blood’s circulation pattern. Blood from the body flows into the right side of the heart, then out to the lungs, back to the left side of the heart where it is pumped to the body, thus completing the circuit. The lungs are excellent filters. They trap small blood clots and injected air bubbles. In actuality, the air bubble would be shattered into microbubbles by the churning action of the right ventricle, which pumps the blood into the lungs, and these tiny bubbles would dissolve into the blood. Any bubbles that survived this “washing machine” would be filtered by the lungs.

Fifty to sixty CCs injected rapidly would travel into the right ventricle, where it could cut off the flow of blood. The beating heart relies upon the non-compressibility of liquids (blood in this case) to squeeze the blood out of the ventricles. Air, as are other gases, is compressible. This produces a sort of “vapor lock,” and almost instantaneous death can result.

[sandman]

50cc's to 60cc's of air is what it would take to stop a heart?  Good lord!  That is a hell of a lot of air!  You know, it only takes 2cc's to 3cc's of air is enough to cause the brakes on your car to fail.  60cc's of air would drain your cars brakes of fluid completely.  Just seems 50 or 60cc's of air in your vascular system would be a bit excessive.

[brenda]

It's true about the air. We used to do it one the C2's. And I chased blood back with air on my C3 for the first couple of years. The only reason I changed to using saline is it is easier for me doing it myself. I didn't like the taste of the heparin at first so even when I was going on my blood was run close to the WHO before my venous line was hooked up.

[Zach]

I don't how true this is but I heard they use to use air (not saline) to push blood back in the patient's system in certain countries.  Its too hairraising to be real.  Probablly a dialysis urban legend.

It's true!  We did it many times.

[kitkatz]

You all make my hair stand on end with these air stories!

[brenda]

The big problem with using air, if you happened to run backwards (venous & arterial reversed) after you unhooked that first needle and turned the pump on.....it was a blood bath! Only happened once but what a mess that was. My son was about ten at the time, him and his buddies  thought it was pretty cool. Not!!

[renal30yrs]

So it was true about the air pumping story.  My gosh!  I thought having formaldehyde mixed in our dialyazer was bad enough.  Any of you remember that burning sensation?

[brenda]

Thank goodness that was before my time. I did talk to a few patient long ago about that. Yikes! I also remember him telling me it took hours to set up the machine, hours to run and hours to tear down. There was only two patients here at that time and their families would take turns bringing them meals. And no nurses available.

[bluedove57]

Yestersday the nurse unclamped a line as the were getting ready to give me my blood back and it spilled all over the floor. She caught it soon enough. When they started to return my blood back the nurse noticed air in the line and clamped it right away. They discarded my blood cause they didn't want to risk air going into my vien. She said it would be painful if it happened. I'm just glad my nurses are very attentive to what they do.