First, prevent further air entrainment by removing the underlying cause: reposition patient, stop intravenous air infusion, flood surgical field, etc.
Increase inspired oxygen fraction FiO2 to 100%.
Turn supine patient to 45-degree left-side down position – “Durant Maneuver.”
Promptly start CPR with chest-compression if no palpable pulse. Compressions may help purge air from heart.
If a central venous (CVP) or pulmonary artery (PA) catheter is present, attempt to aspirate air from the right atrium.
Use pharmacological hemodynamic support as needed, including inotropes (dobutamine) and vasoconstrictors (phenylephrine, norepinephrine) to support systemic blood pressure.
Hyperbaric oxygen therapy: unproven but supported by some clinical evidence.
Intravenous fluorocarbons: unproven in humans, supported by animal studies.
Complete an in-depth chart review of hospital-associated AE events. Identify trends such as:
Service line.
Physician.
Diagnosis.
Risk factors.
Hospital units.
Patient mobility.
Identify gaps in care that increase risk for AE development.
Implement interventions that reduce AE risk.
Ensure interventions are patient-centered
Incorporate AE Risk Assessment into EHR for all new admissions.
Reassess risk periodically upon change in level of care, clinicians, and prior to discharge.
Understand your staff’s perception of the importance of AE precautions.
Consider yearly competence in AE prevention, detection, treatment.
Ensure that all team members - physicians, nurses, patient care assistants, trainees, pharmacists, transport personnel, physical therapists, patients and family members are aware of their roles in AE-prevention.
Educate patients and families about the risks, complications, the importance of AE prophylaxis, and the symptoms of AE.