Air Embolism Medical Malpractice

With intravenous therapy there is a risk of air embolism, that is, air bubbles entering the vein system from the failure to have the fluid fill up the entire plastic line prior to connection to the catheter or needle. Sometimes the intravenous bottle will run dry, and the nurse will connect another bottle without observing a substantial amount of air in the line. This air can cause damage by entering the heart, and if in a significant amount, obstruct blood flow through the heart into the lungs, somewhat like a blood clot in a pulmonary embolism.

The emergency treatment is placing the patient on their left side downward (with the body tilted in a leg upward, head downward position). This removes the air bubble from the tricuspid and pulmonic valve openings, allowing blood to go through its circuit to the lungs, while the air bubble is in a more innocuous position at the very bottom portion of the heart (apex), where it will be absorbed slowly over a few hours.

Sometimes a patient will have a congenital type of heart disease where there is a communication between the right atrium and left atrium, bypassing the filtering circuit of the lungs. Air entering the right atrium with this congenital heart defect can go directly into the left atrium when there is this "right to left" shunt flow of blood, and from there into the left ventricle and out into the aorta, the main artery of the body. If these air bubbles enter the cerebral circulation (the arteries to the brain) this will result in a stroke. Entering the blood vessels in other portions of the body usually is not serious as most areas of the body's flesh can withstand a number of hours of oxygen deprivation while the air bubbles are absorbed. The brain, however, can only withstand a few minutes of absence of oxygen before irreversible damage occurs.

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