Review Note
Last Update: 12/13/2023 09:07 PM
Current Deck: 1 CRNA::Apex Ankisthesia::Ankisthesia::M&M::27 Anesthesia for Neurosurgery
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Hypotension due to a venous air embolism should be treated with {{c1::vasopressors}}.
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Step wise treatment of a Venous Air Embolism:
1. Notify the surgeon so they can flood the surgical field with saline or pack it.
1. Notify the surgeon so they can flood the surgical field with saline or pack it.
2. NO should be discontinued & patient ventilated with 100% O2.
3. If central venous catheter in-situ, aspiration of the emobli should be attempted.
4. Fluid bolus given to increase central venous pressure (slows air entrainment & encourages back bleeding, helping the surgeon locate the point of entry).
5. Vasopressors given to treat hypotension.
6. Bilateral jugular vein compression to increase intracranial venous pressure.
7. PEEP to increase cerebral venous pressure. This can reversal of normal transatrial pressure gradient. However, it may encourage a paradoxical embolism if patient has a foramen ovale.
8. If measures fail, place patient in a head down position & quickly close wound.
9. Initiate advanced resuscitation in supine position if circulatory arrest persists
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