Air embolism treatment: Emergency care and recovery

An air embolism is a rare event where air bubbles enter the bloodstream. These air bubbles can cause potentially life threatening complications such as heart attack or stroke. 

This article explores treatment of air embolisms, as well as potential causes and how doctors diagnose air embolism.

Immediate treatment of air embolism

Quickly identifying and treating air embolism can help prevent serious complications and death. 

If you think you or someone you know may be experiencing air embolism, it’s essential to seek emergency medical care right away. 

To treat an air embolism, healthcare professionals may: 

• Perform life-saving first aid: If you’re unresponsive, the medical team will prioritize airway, breathing, and circulation (ABC) first aid treatment, as well as cardiopulmonary resuscitation (CPR).
• Consider Durant’s maneuver: To encourage the air bubble to move and reduce the risk of serious health issues, healthcare professionals may turn you on your left side with your head down and feet up. 
• Hyperbaric oxygen therapy (HBOT): A common air embolism treatment involves receiving 100% oxygen while inside a hyperbaric chamber. This increases oxygen delivery to tissues and can help dissolve and eliminate air bubbles from the bloodstream.

Ongoing treatment options for air embolism

After immediate life-saving treatment, doctors may admit you to an intensive care unit (ICU) for treatments such as intravenous (IV) fluids and medications.

The following medications may help improve health outcomes in people with air embolism:

• blood thinners such as heparin (Hep-Pak, Heparin, Hep-Lock)
• anti-inflammatory medications such as doxycycline (Acticlate, Adoxa CK, Doryx)
• antiarrhythmic (heart rhythm-changing) medications such as lidocaine (Xylocaine HCI, Lidoject, Dilocaine) 

What is an air embolism and how do you get one?

An air embolism, or gas embolism, happens when air or gas enters a blood vessel. 

Possible causes include:

• cannulation of central veins, which involves inserting a tube into large veins for medical procedures
• head and neck surgery
• blunt or penetrating chest trauma 
• thoracentesis, a procedure to remove fluid from the space between the lung and chest wall
• hemodialysis, a treatment to filter waste and extra fluids from the blood when the kidneys don’t function properly
• high pressure mechanical ventilation
• diving, when scuba diving, pressure changes can cause gas to enter the bloodstream.
• injection of radiocontrast for computed tomography (CT) scans

Diagnosis of air embolism

A healthcare team will assess the following to diagnose an air embolism:

• Physical symptoms: Symptoms such as chest pain, seizures, and coughing can indicate air embolisms. 
• Changes in heart behavior: Heart changes such as a drop in blood pressure or an irregular heart rhythm are other signs of air in the bloodstream. 
• Chest X-ray: These scans can detect large air bubbles.
• IV pump: These pumps sometimes have built-in alarms that go off when air is present.
• End-tidal measurements: These measure which gasses are present in the air you breathe out. An increase in nitrogen or a decrease in carbon dioxide can indicate air embolisms. 
• Other detective measures: Listening for heart murmurs using a stethoscope or detecting blood density changes using a Doppler ultrasound are other ways to identify heart and vascular system changes, including embolisms. 

Long-term risks and effects

The long-term effects of air embolisms depend on the severity of your condition and whether you receive treatment.

The severity of air embolisms depends on several factors, including:

• the rate of air or gas accumulation
• the volume of gas or air 
• the person’s position at the time of the event
• how close to the heart the air or gas entered the veins

Most cases of air embolisms are benign, don’t cause symptoms, and don’t require treatment. 

But a large air embolism can lead to serious complications such as organ damage, stroke, or heart attack.

Preventing air embolisms

Most cases of air embolisms occur during medical procedures. Medical professionals should take precautions to ensure that air does not enter the bloodstream during procedures such as catheterization or surgery. 

If you’re a scuba diver, be sure to always adhere to safety instructions to reduce your risk of this rare medical event. 

Summary

Air embolism is a rare but potentially life threatening condition that requires immediate treatment. 

Medical professionals can use air embolism treatments such as HBOT, positional changes, and certain medications. 

If you suspect that you or someone you know is experiencing an air embolism, seek immediate medical attention.

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