Gas Embolism Health Article

Definition

Gas embolism, also called air embolism, is the presence of gas bubbles in the bloodstream that obstruct circulation.

Description

Gas embolism may occur with decompression from increased pressure; it typically occurs in ascending divers who have been breathing compressed air. If a diver does not fully exhale upon ascent, the air in the lungs expands as the pressure decreases, overinflating the lungs and forcing bubbles of gas (emboli) into the bloodstream. When gas emboli reach the arteries to the brain, the blood blockage causes unconsciousness. Gas embolism is second only to drowning as a cause of death among divers.

Gas embolism may also result from trauma or medical procedures such as catheterization and open heart surgery that allow air into the circulatory system.

Causes and symptoms

Gas embolism occurs independent of diving depth; it may occur in as little as 6 ft of water. It is frequently caused by a diver holding his breath during ascent. It may also result from an airway obstruction or other condition that prevents a diver from fully exhaling.

The primary sign of gas embolism is immediate loss of consciousness; it may or may not be accompanied by convulsions.

Diagnosis

Any unconscious diver should be assumed to be the victim of gas embolism, regardless of whether consciousness was lost during or promptly after ascent. A doctor may also find pockets of air in the chest around the lungs and sometimes a collapsed lung from overinflation and rupture. Coughing up blood or a bloody froth around the mouth are visible signs of lung injury.

Treatment

Prompt recompression treatment in a hyperbaric (high-pressure) chamber is necessary to deflate the gas bubbles in the bloodstream, dissolve the gases into the blood, and restore adequate oxygenated blood flow to the brain and other organs. Recompression by returning the diver to deeper water will not work, and should not be attempted. The patient should be kept lying down and given oxygen while being transported for recompression treatment.

Before the diver receives recompression treatment, other lifesaving efforts may be necessary. If the diver isn't breathing, artificial respiration (also called mouth-to-mouth resuscitation or rescue breathing) should be administered. In the absence of a pulse, cardiopulmonary resuscitation (CPR) must be performed.

Prognosis

The prognosis is dependent upon the promptness of recompression treatment and the extent of the damage caused by oxygen deprivation.