Quality & Safety

Air-in-Line Alarms: Decreasing Alarms Through Antisiphon Valve Implementation

Karen Meade

Kimberly Catania

Ben Lopez

Ryan Connell

antineoplastic protocols, drug delivery, infusion pumps, clinical alarms
CJON 2019, 23(2), 209-211. DOI: 10.1188/19.CJON.209-211

The administration of 24-hour continuous chemotherapy infusions is common in certain regimens, such as EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin). Such regimens are notorious for clinically insignificant air-in-line (AIL) alarms because of the naturally bubbly composition of the drugs involved. An antisiphon valve, placed at the end of the IV tubing to pressurize the infusion and to minimize air bubbles, was found to decrease clinically insignificant AIL alarms. The positive outcomes of the current study could be applied to other infusions known for frequent clinically insignificant AIL alarms.


  • Nuisance AIL alarms may prolong infusion times, disrupt patients’ sleep, and increase nursing workflow. 
  • A 92% decrease in AIL alarms was observed when comparing four weeks of infusion data before and after antisiphon valve implementation.
  • The antisiphon valve must be manually primed via syringe or IV pump because it cannot be primed by gravity.
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