UHMS 01 Air or Gas Embolism

#GasEmbolism #AirEmbolism #HBO2 #HyperbaricOxygenTherapy #WoundCare #MedicalEmergency #DivingSafety #Iatrogenic #PFO #NeuroEmergency #HBOT #UHMS #DrGregoryWeir
Gas embolism involves gas bubbles in blood vessels, classified as arterial (AGE) or venous (VGE). Causes include pulmonary barotrauma from compressed gas ascent, iatrogenic sources during medical procedures, paradoxical embolism via shunts like a PFO, and hydrogen peroxide ingestion. AGE often presents with sudden, stroke-like neurological deficits; significant VGE causes cardiopulmonary symptoms. Diagnosis is clinical based on a plausible mechanism and presentation. Imaging like CT/MRI is insensitive for gas and primarily used to rule out other conditions. Immediate management involves airway, blood pressure support, 100% oxygen, avoiding nitrous oxide, and supine positioning. Definitive treatment is Hyperbaric Oxygen Therapy (HBO2), which compresses bubbles, facilitates gas washout, and reduces inflammation. HBO2 improves outcomes and reduces mortality. Prompt treatment is best, but benefit can still occur with delays. HBO2 for AGE/symptomatic VGE is an AHA Class I, Level C recommendation. Causes are varied across clinical settings.

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