Reply To: Management of Air in Line

  • Kimberly Duback

    October 2, 2018 at 10:30 am

    The first plan of action is to see if the air can be moved back into the drip chamber by manipulating the tubing without opening the line. We try to avoid opening the line at all costs. This seems to work most of the time.  If absolutely needed, we could use a syringe; however, we would attached a CSTD (we use OnGuard) to access the line. We try to avoid this not only for exposure but also so as to not lose drug.  I have never seen a method of attaching an additional bag so I am curious to understand that workflow. Lastly, I can only think of one instance where we had so many champagne bubbles in the line and troubleshooting was unsuccessful so we went the bag/tubing back to pharmacy to re-prime the med under the hood.

    Kimberly Duback, MS, APN, PCNS-BC, CPN, CPHON
    Advanced Practice Nurse
    Advocate Children’s Hospital
    United States of America
    Original Message:
    Sent: 09-28-2018 07:31 AM
    From: Chris Donaghey
    Subject: Management of Air in Line

    Many of us are reflecting on USP 800 guidelines and in doing so, are trying to support or refine current practices to stay as safe as possible.

    One area of concern we have, for ourselves and even non-oncology areas, are management of air that gets into IV tubing.

    Specific to hazardous drugs, how does your facility address actual air in the tubing?

    Are nurses getting into that tubing with closed system transfer devices? Are additional bags being attached? Is the tubing being replaced?

    This is not a question of preventing air in line; more focused on if it’s there.

    I’ve seen and heard variations, both in my practice and from colleagues.


    Chris Donaghey, MSN, RN, PCNS-BC, CPN, CPHON
    Clinical Nurse Specialist – Riley Cancer Center
    Riley Hospital for Children at IU Health
    Indianapolis, IN