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Arterial Gas Embolism (AGE), Emergency Medicine

Nicole L. Lunceford, Catherine M. Visintainer and Peter J. Park Reviewed 06/2017
 


Basics

Description

  • Results when air bubbles enter the pulmonary venous return from ruptured alveoli, then propagate through the systemic vasculature:

    • Clinical manifestations depend on location of air bu...

Diagnosis

Signs and Symptoms

  • Cerebral:

    • Rapid onset:

      • Almost all cases of AGE present within 1st 5 min of surfacing, although most often symptoms are evident in 1st 2 min

    • Dive-related stroke

    • 2 main presentat...

Treatment

Pre-Hospital

  • Cautions:

    • Patients who experience sudden neurologic recovery can relapse quickly as bubble positions change.

    • Recognize AGE as a potential diagnosis.

  • Altered mental status within 10 ...

Follow-Up

Disposition

Admission Criteria

Admit all following initial hyperbaric therapy for observation and re-exam. 

Discharge Criteria

No AGE patients should be discharged from the ED. 

Followup Recommendations

Pearls and Pitfalls

  • Symptoms occur during ascent or within 10 min of reaching the surface.

  • Patients who experience sudden neurologic recovery can relapse quickly as bubble positions change.

  • Fill endotra...

Additional Reading

  • Hawes  J, Massey  EW. Neurologic injuries from scuba diving. Neurol Clin.  2008;26:297–308.

  • Levett  DZ, Millar  IL. Bubble trouble: A review of diving physiology and disease. Po...

Codes

ICD9

958.0 Air embolism 

ICD10

T79.0XXA Air embolism (traumatic), initial encounter 

SNOMED

  • 302968001 Arterial air embolus

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