Embolism is a blockage of a vein or artery that causes blood flow to stagnate. This can have serious consequences. The most common occurrence is thromboembolism. This is caused by a blood clot. We also have fat embolism and air embolism. With an air embolism, air or gas bubbles enter the bloodstream. These can cause closure of the (artery) vein. The causes are often surgery or diving. The symptoms are clearly recognizable, shortness of breath often occurs first. Treatment is necessary because air embolism can lead to death.
What is an air embolism?
Another name for air embolism is aeroembolism. This is an embolism caused by air. but what is an embolism? An embolism involves a blockage of an artery or another. When we speak of embolism, we mean the occlusion of a vein or artery causing a blood clot. This is also called thromboembolism. But there are several forms of embolism, including fat embolism and air embolism.
Causes
Air is the cause of an air embolism. This enters the bloodstream (vein or artery) and forms an air bubble there. In this way the vein is closed and blood can no longer flow through it. The question is how this air gets into the vein.
In many cases the cause can be found in an open vein into which air is sucked in. Consider, for example, an operation, an infusion or dialysis. Another cause is an increase in pressure in the lungs. This occurs, for example, with divers and caisson employees. We also call this the caisson disease or decompression sickness. But how does this arise? Inhaled air consists of 80 percent nitrogen and only 20 percent oxygen. The body’s ambient pressure is also 80 percent nitrogen. So we are set up for this. Far under water the ambient pressure is higher. This causes the lungs to expand because the partial pressures in the lungs become higher than those of the dissolved gases. If the diver ascends too quickly, the pressure drops too quickly. This releases nitrogen into the blood in the form of gas bubbles. This can block the arteries or veins. We now speak of air embolism.
A blood vessel in the lungs may rupture. This forces air into the veins, coming from the alveoli. The air flows into the bloodstream via the left side of the heart. This phenomenon mainly occurs with divers who ascend too quickly.
Symptoms
The signs or symptoms of air embolism may be similar to those of thromboembolism. In addition, it depends on where the air is located and what the patient’s position is. When lying down, the air goes to the right side of the heart. The air ends up in the atrium or the heart chamber. The pumping action of the heart in combination with the presence of air causes foam to form. This foam formation blocks the passage of blood. As a result, the lungs no longer receive any or insufficient blood supply. Symptoms include shortness of breath, shortness of breath, deep breathing and coughing. Cyanosis occurs as a result of oxygen deficiency. With cyanosis, the skin turns blue to blue-gray. The oxygen saturation in the blood is too low.
Eventually the patient becomes unconscious. The patient no longer responds to external stimuli. Pain stimuli cannot wake the patient either. Breathing will become increasingly slower and the heart will eventually stop beating due to a lack of oxygen. Without treatment this is fatal.
In a sitting position, air will rise to the brain. This is because the gas or air bubbles formed always find their way upwards. The small blood vessels in the brain are blocked by the air. This means that the blood can no longer flow. The patient mainly hears a murmur that occurs in the blood vessels due to the air that rises. This can be very serious for the patient and they may look confused or reacting. Because the brain is less well supplied with blood, cramps and spasms occur. Without treatment, this can also be fatal.
Therapy
Air embolism does not go away on its own and must always be treated. Without treatment, the consequences are very serious and death can follow. When the patient is lying down, it is important that he or she is not lying on the right side. When lying on the right side, the air will move towards the lungs. There too, the air blocks the veins or arteries. Therefore, always place the patient on the left side. Because the air wants to rise, it is wise to put your head down and your feet up. This forces the air to rise towards the feet. As long as the air is diverted away from the heart, lungs and brain!
Administering oxygen is a first treatment. This concerns 100% oxygen, which is available at many diving clubs. Doctors also have this available. In addition, the other symptoms will be treated. Divers will be treated in a decompression tank. This must be done as quickly as possible. The excess nitrogen will dissolve in a decompression tank. This is then exhaled. The air pressure is slowly adjusted back to the normal level. In a decompression tank, 100% oxygen is often added. This way, no more nitrogen is added and the nitrogen dissolves faster.
If air embolism occurs as a result of surgery or other medical treatment, the doctor will immediately administer oxygen and treat the other symptoms. Because first aid is immediately available here, the consequences will often be minimal. but if air embolism occurs and treatment is not provided for some time, a cerebral infarction or myocardial infarction may occur. This can cause permanent damage.
