air bolus in swan gantz

meandragonbrett · Nov 19, 2010

What part was air being injected into?

3ccBolus · Nov 19, 2010

Whoa, that's pretty bad. Yes- If you introduce air into a line that is inside the patient, an air embolus can occur. I think the balloon (I assume that's what they were trying to inflate) generally holds about 1.5ml of air, depending on manufacturer. Hopefully 1.5 wouldn't cause an embolus, but it wouldn't do them any favors. The possibility exists though, especially if he/she kept refilling the syringe with air to try again. That person really needs some more education before working with swans.

jkej · Nov 19, 2010

The doc never mentioned which port was actually used.

aCRNAhopeful · Nov 19, 2010

It wouldn't be any worse than injecting air into a central line right? Certainly not good practice but unlikely to cause harm.

chare · Nov 20, 2010

the following was copied from venous air embolism: emedicine emergency medicine.

generally, small amounts of air are broken up in the capillary bed and absorbed from the circulation without producing symptoms. traditionally, it has been estimated that more than 5 ml/kg of air displaced into the intravenous space is required for significant injury (shock or cardiac arrest) to occur. however, complications have been reported with as little as 20 ml of air (the length of an unprimed iv infusion tubing) that was injected intravenously. the injection of 2 or 3 ml of air into the cerebral circulation can be fatal. furthermore, as little as 0.5 ml of air in the left anterior descending coronary artery has been shown to cause ventricular fibrillation. basically, the closer the vein of entrainment is to the right heart, the smaller the lethal volume is.

stram87 · Dec 14, 2010

Our swan gantz caths have a syringe attached that cannot be removed and only allow you to inflate the ballon with 1.5ml of air. While it doesnt seem likely that 1.5ml of air could cause major problems it is certainly possible.