Air embolism primary prevention

• 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.

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.

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