Does air bubble in IV cause damage?

Dear Dr. roach: A few years ago, when I was being prepared for a colonoscopy and gastroscopy, I was given an IV line in my right arm with a sedative in it. As I waited to pass out, I saw a large bubble move slowly along the IV line to my arm. I was concerned about an air embolism and called the nurse, who pooh-poohed my concern: β€œIt’s just a bubble! It won’t hurt you.” I insisted to see the nurse on duty, who came over to me, turned off the IV and waved her finger over the line several times so that the air bubble went up in the line. Then she squeezed closed the line, turned the IV back on and tapped the line a few more times, until the air bubble floated in the IV bag and waddled up, she released her sniff on the IV line and said, “There. Are you happy now?” ” and walked away.

Was I right to be concerned? I’m glad the sedative hadn’t kicked in when the problem arose! But I would like to know the answer, just in case this happens again.

β€” FM

Best FM: Before medical school, I had also heard that injecting air into a vein can be fatal, so I understand why you were concerned. However, I have learned that the amount of air it takes to do damage is VERY large. An air bubble can be 0.2 cc and still look quite significant in the IV tubing. The minimum amount that can cause symptoms is a hundred times as much, 20 cc, but it probably takes a lot more to be fatal, usually over 150 cc. I bet nurses hear those concerns often. But it doesn’t excuse her behavior, which sounded quite rude as you describe it.

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