INSERTION-RELATED COMPLICATIONS

Air Embolus

During a CVC insertion, air may accidentally enter the blood vessel and travel to the heart. This can result from air in the flush syringe or exposure of the open catheter lumen to atmospheric pressure causing air to move towards the catheter tip.

Symptoms of air embolus include:

• Palpitations
• Chest pain
• Shortness of breath
• Shoulder or back pain
• Cyanosis
• Tachycardia
• Hypotension

Prevention/Management
Maintain a "closed system" throughout the insertion procedure, prime the catheter prior to insertion and keep the insertion site below the heart when open to the air. Should air emboli be suspected, management would include maintaining the patient in the left-sided Trendelenberg position, checking patient's vital signs, administer 100 percent oxygen and preparing for a possible code situation (11).