Journal of Marine Science: Research & Development
Open Access

Abstract

Air embolism results from vascular occlusion due to a significant amount of air trapped in a patient?s bloodstream, representing a leading cause of death among SCUBA divers, perioperatively and other patients usually undergoing invasive procedures. Arterial Gas embolism (A.G.E.), leads to Cerebral Gas Embolism (C.G.E), when gas bubbles traverse the blood brain barrier resulting in CVA, Cerebral edema, seizures, and multitudes of focal neurological deficits. Venous Gas embolism (V.G.E), involves air or gas bubbles occluding veins, and is usually non-fatal, unless bubbles gain access to the systemic circulation. We elucidate the clinical features, dire consequences and preventive measures of air and arterial gas embolism distinguished by whether ambient air vs. a mixture of pressurized gases is utilized by divers and other patients. The pathophysiology, signs & symptoms, several diagnostic modalities deployed in rapid triage of this life-threatening constellation of syndromes are reviewed. We explore evidence-based preventive measures and therapeutic modalities, effective forms of supplemental oxygen therapy, proper patient positioning and thereby preventing propagation of air bubbles, through a Patent Foramen Ovale (PFO) which may be present in 27-30% of the population, potentially resulting in coronary vascular occlusion, Myocardial infarction and dangerous dysrhythmias. Additional ominous clinical consequences of vascular occlusion in the CNS, Kidneys or extremities lead to necrosis and eventual organ failure, without timely triage. Breath-holding during accelerated rapid ascent after a prolonged deep dive, with a paucity of residual gases remaining and dangerous pressure gradients arising from indiscriminate high altitude air travel shortly before or after diving must be avoided. Meticulous adherence to NAVY Dive tables, compliance with Diver Alert Network (DAN) guidelines must be followed thus to ensure maximal survival rates. A rapid triage sequence is an imperative limiting long-term disability, expedient diagnosis, prudent use of diagnostic modalities, without delay of the formidable and measurable benefits of Hyperbaric Oxygen Therapy (HBOT) and facilitation of safe transport to tertiary referral centers, equipped for administering HBOT.

Biography

George Schroeder is a graduate of the University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada, in addition to having earned a MS in Healthcare Management from the University Of Texas School Of Graduate Management, affiliated with the South Western Medical School, Dallas, Texas. He is a member of the Beta Gama Sigma International Honor Society 2008. Currently he serves as Executive Director of Medical Affairs for the American Academy of Urgent Care Medicine, as well as a member of the Board of Directors of the American Board of Urgent Care Medicine. He is a Clinical Assistant Professor of Emergency Medicine at the University Of Central Florida College Of Medicine, in Orlando, Florida.