Diagnosis
The clinical symptoms play an important role in the diagnosis of air embolism. If there is a temporal connection with a medical intervention, infusion, catheter examination or similar, this must be reported. Air embolism can be detected directly with the heart ultrasound device. Changes in the ECG (electrocardiogram) that resemble a heart attack are often seen. In most cases, a drop in oxygen content can be detected in the blood gas analysis.
Associated symptoms
If an air embolism develops, there are certain symptoms that can occur individually or together. A strong cough and pain when breathing up to shortness of breath are possible symptoms. Accelerated breathing, tachypnea, is also common.
Those affected can suffer from syncope (circulatory collapse, short-term unconsciousness) and anxiety, even panic. Sweating frequently occurs. If the air embolism occurs in a brain vessel, neurological deficits are to be expected.
The symptoms can then resemble a stroke.
- How can a pulmonary embolism be detected? What are the typical signs?
- Circulatory disorder in the brain
In general, the entry of air into a vessel of any quantity must be viewed extremely critically.
The consequences are strongly dependent on how much air enters, at what speed and what the condition of the person concerned is. Smaller gas accumulations in the veins are in most cases resorbed. It becomes dangerous when a larger amount of air (>100 ml air) enters the right ventricle.
A gas supply of more than 100 ml air per second or more is usually fatal. In the arterial system, significantly smaller amounts of air are dangerous. Just 2 ml of air can lead to a stroke in the cerebral arteries and only 0.5 ml of air in the coronary arteries can cause a heart attack. The amount of air needed for an air embolism therefore depends on the location and the vessel (artery or vein).
Therapy of air embolism
In the therapy of air embolism, immediate measures are important and can save lives. The first measure is to eliminate the cause of air embolism. Any further inflow of air into the vessel must be prevented.
Depending on the extent of the air embolism and the symptoms, it may be necessary to ventilate the patient. In some cases, a central venous catheter can be used to aspirate air from the right atrium. One method of treatment is compression therapy with bandages, stockings, depending on the location and cause of the air embolism.
The Durant maneuver can help to prevent increasing embolization of the lungs. During this positioning, the patient is placed in a left-side position with head-down position. Depending on the symptoms, it may be necessary to take measures to stabilize the circulation (medication, shock positioning).
If necessary, resuscitation may be necessary. As an immediate measure, the cause of the air embolism must be prevented, i.e. the further inflow of air into the vessel must be prevented. If the air embolism is very pronounced, immediate ventilation of the patient may be necessary.
To prevent further embolization of the lung, the Durant maneuver can be helpful. In this position, the patient is placed in a left-sided position with the head down. The aim is to ensure that the air remains in the right ventricle and does not reach the pulmonary vessels. In severe cases, resuscitation may be necessary.
