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Air embolism

1934

An air embolism, also called a gas embolism­.

Decompression sickness and arterial gas embolism are collectively referred to as decompression illness.

Occurs when one or more air bubbles enter a vein or artery and block it.

An air bubble entering a vein, is called a venous air embolism.

An air bubble enters an artery, is called an arterial air embolism.

Air bubbles can travel to the brain, heart, or lungs and cause a heart attack, stroke, or respiratory failure.

Air embolisms are rare.

Occur when veins or arteries are exposed and pressure allows air to travel into them:

Injections and surgical procedures can accidentally inject air into veins.

Air can also enter veins or arteries through a catheter inserted into them.

Air entering veins and arteries during surgical procedures is most common during brain surgeries.

Up to 80 percent of brain surgeries result in an air embolism.

Ventilator could force air into a damaged vein or artery.

Air embolism can occur during scuba diving as activity can cause alveoli, to rupture with air moving to arteries, resulting in an air embolism.

Explosion and blast injuries can cause veins or arteries to open pushing air into injured veins or arteries.

Blowing air into the vagina during oral sex can rarely cause an air embolism if there’s a tear or injury in the vagina or uterus.

The risk is higher in pregnant women, who may have a tear in their placenta.

Minor air embolism may cause no symptoms.

Symptoms of a severe air embolism include:

difficulty breathing or respiratory failure

chest pain or heart failure

muscle or joint pains

stroke

mental status changes

Hypotension

blue skin hue

Diagnosis: use of precordial Doppler ultrasonic systems, right central venous or atrial catheters, and transesophageal echocardiography (TEE) can help in the early detection.

TEE and Doppler are the most sensitive in detection.

Treatment goals:stop the source of the air embolism and prevent damage.

Treatment includes: aspiration of the air through a right atrial catheter, discontinuation of nitrous oxide, administration of pure oxygen, sealing possible portals of air entry, and repositioning the patient in the left lateral decubitus position may further facilitate air removal.

Hyperbaric oxygen therapy can cause an air embolism to shrink so it can be absorbed into your bloodstream without causing any damage.

Small embolisms generally dissipate and do not cause serious problems.

Large air embolisms can lead to strokes, heart attacks and could be fatal.

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