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Arterial Gas Embolism

Epidemiology
1. Accounts for 25% of annual fatalities in divers
Pathophysiology
1. Scuba injury resulting from Pulmonary Barotrauma
2. Free air entry into pulmonary vasculature
3. Air bubbles travel to heart and brain
4. May result in Cerebrovascular Accident events
5. Neurologic symptoms predominate
Symptoms (within 5 minutes of ascent in 80% cases)
1. Altered Level of Consciousness
  1. Stupor or confusion (24%)
  2. Coma without Seizures (22%)
  3. Coma with Seizures (18%)
2. Unilateral motor deficits (14%)
3. Visual disturbances (9%)
4. Vertigo (8%)
5. Unilateral sensory deficits (8%)
6. Bilateral motor deficits (8%)
Management
1. Supplemental Oxygen (100%)
2. Observe and treat associated conditions
  1. Seizure
  2. Arrhythmia
  3. Shock
  4. Hyperglycemia
3. Recompression Therapy
References
1. Clenney (1996) Am Fam Physician 53(5):1761
2. Newton (2001) Am Fam Physician 63(11):2211

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 2/26/2010. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.