Health encyclopaedia

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Diagnosis of Air embolism

Divers should always be carefully monitored by their colleagues and supervisors, and any suspicion of embolism will be brought to medical attention. The symptoms will usually appear within 8 hours of resurfacing, but they can appear after just a few minutes. Their main symptom for divers is often pain in the joints, but itching or mottled skin are also common. A physical examination and tests such as chest X-rays may be carried out to check that the symptoms are not being caused by another condition.

There are several methods for monitoring a patient during surgery, if they might be at risk from air embolism.

Transesophageal echocardiography – inserting a scanner into the body through the mouth and down the airway, in order to monitor the heart with ultrasound. This can detect relatively small air bubbles, but it is invasive (requires medical instruments to enter the body) and does not pinpoint where the embolus is in the body.

Doppler ultrasound – an ultrasound scanner placed over the right side of the heart to measure the speed of blood flow and changes in blood density. It is quite sensitive and is commonly used during neurosurgical procedures. However, it cannot detect the size of the embolus so it cannot tell the difference between life-threatening and minor air pockets. It can also sometimes be difficult to place the equipment on the patient, especially if they are obese.

Pulmonary artery catheter – a tiny tube inserted into the artery connecting the heart to the lungs. By monitoring blood pressure in this artery, it can show that an air embolism may be present. However, changes in blood pressure could also be caused by other factors, so this is not a routine method of monitoring. 

Stethoscope - placed on the chest, a stethoscope can be used to monitor the sound of the heart, but this is the least sensitive method of monitoring.

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