Air embolism primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
- There are many different techniques that physician can use to prevent air embolism during a invasive procedure.
- Deep sea divers can prevent air embolism with adequate monitoring of their dive.
Primary Prevention
During Venous catheter placement:[1]
- Place patient in Trendelenburg position
- this increases the CVP
- Adequate hydration [2]
- Avoid placement during inspiration
- Flush catheter lumens
During Venous catheter removal:[3] [4]
- Place patient in Trendelenburg position
- Remove Catheter during valsalva or expiration
- Cover site and apply pressure for 5-10 minutes
- Patient should remain supine for 30 minutes post procedure
During other Invasive procedures:[5]
- Use of a flush in a closed system
- Prime tubing with saline
- No air should be present in syringes
- Intra operative use of precordial doppler
- Avoid use of Nitrous oxide during abdominal procedures
- "park bench position" should be used for surgeries performed in the sitting position[6]
- Use of Reverse Trendelenburg position during Cesarian section[7]
During deep sea diving monitoring gas levels and rate of ascent can help prevent DCS.
References
- ↑ Colin J. McCarthy, Sasan Behravesh, Sailendra G. Naidu & Rahmi Oklu (2016). "Air Embolism: Practical Tips for Prevention and Treatment". Journal of clinical medicine. 5 (11). doi:10.3390/jcm5110093. PMID 27809224. Unknown parameter
|month=ignored (help) - ↑ C. M. Domaingue (2005). "Neurosurgery in the sitting position: a case series". Anaesthesia and intensive care. 33 (3): 332–335. PMID 15973915. Unknown parameter
|month=ignored (help) - ↑ Colin J. McCarthy, Sasan Behravesh, Sailendra G. Naidu & Rahmi Oklu (2016). "Air Embolism: Practical Tips for Prevention and Treatment". Journal of clinical medicine. 5 (11). doi:10.3390/jcm5110093. PMID 27809224. Unknown parameter
|month=ignored (help) - ↑ P. Ingram, Linda Sinclair & Toby Edwards (2006). "The safe removal of central venous catheters". Nursing standard (Royal College of Nursing (Great Britain) : 1987). 20 (49): 42–46. doi:10.7748/ns2006.08.20.49.42.c4483. PMID 16939143. Unknown parameter
|month=ignored (help) - ↑ Colin J. McCarthy, Sasan Behravesh, Sailendra G. Naidu & Rahmi Oklu (2016). "Air Embolism: Practical Tips for Prevention and Treatment". Journal of clinical medicine. 5 (11). doi:10.3390/jcm5110093. PMID 27809224. Unknown parameter
|month=ignored (help) - ↑ T. Mammoto, Y. Hayashi, Y. Ohnishi & M. Kuro (1998). "Incidence of venous and paradoxical air embolism in neurosurgical patients in the sitting position: detection by transesophageal echocardiography". Acta anaesthesiologica Scandinavica. 42 (6): 643–647. PMID 9689268. Unknown parameter
|month=ignored (help) - ↑ J. Fong, F. Gadalla & M. Druzin (1991). "Venous emboli occurring caesarean section: the effect of patient position". Canadian journal of anaesthesia = Journal canadien d'anesthesie. 38 (2): 191–195. PMID 2021988. Unknown parameter
|month=ignored (help)