• J A Williamson, R K Webb, W J Russell, and W B Runciman.
• Department of Anaesthesia and Intensive Care, University of Adelaide, S.A.
• Anaesth Intensive Care. 1993 Oct 1; 21 (5): 638-41.

AbstractThere were 19 cases of air embolism (1%) among the first 2000 incidents reported to the Australian Incident Monitoring Study. No embolism-induced fatalities were reported. Serious acute systemic effects occurred in 14 incidents; one circulatory arrest required electrical counter-shock. 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. Capnography was the most successful first detector (26%) and it confirmed the diagnosis in another 26%. Invasive blood pressure monitoring, the electrocardiograph and the pulse oximeter played a useful role in detecting and/or confirming air embolism. Doppler monitoring was not reported in this series. A successful first response for management included 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; hyperbaric oxygen therapy should be considered.

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