AIR-EMBOLISM - AN ANALYSIS OF 2000 INCIDENT REPORTS

There were 19 cases of air embolism (1%) among the first 2000 incident s reported to the Australian Incident Monitoring Study. No embolism-in duced fatalities were reported Serious acute systemic effects occurred in 14 incidents; one circulatory arrest required electrical counter-s hock. The surgical field was the entry route for the air in 63% of the incidents; 47% of the cases occurred during head and neck surgery. Ca pnography was the most successful first detector (26%) and it confirme d the diagnosis in another 26%. Invasive blood pressure monitoring, th e electrocardiograph and the pulse oximeter played a useful role in de tecting and/or confirming air embolism. Doppler monitoring was not rep orted in this series. A successful first response for management inclu ded head-down posture, manual ventilation, 100% oxygen and control of the air entry site. Cerebral arterial gas embolism may induce vascular endothelial damage and possible delayed neurological sequelae, hyperb aric oxygen therapy should be considered.