Education  |   October 2017
Point-of-care Ultrasound Detection of Intraoperative Venous Air Embolism
Author Notes
  • From the Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts.
  • Address correspondence to Dr. Vo: daniel.vo@childrens.harvard.edu
Article Information
Education / Images in Anesthesiology / Radiological and Other Imaging
Education   |   October 2017
Point-of-care Ultrasound Detection of Intraoperative Venous Air Embolism
Anesthesiology 10 2017, Vol.127, 711. doi:10.1097/ALN.0000000000001711
Anesthesiology 10 2017, Vol.127, 711. doi:10.1097/ALN.0000000000001711
POINT-OF-CARE ultrasound is used widely in emergency medicine departments and intensive care units to reduce diagnostic delay and guide medical decision-making in real time.1,2  We present ultrasound images of a basic perioperative transthoracic echocardiogram examination performed during the resuscitation of a 16- month-old girl who presented for an open hip reduction and experienced an acute decrease in her end-tidal carbon dioxide, heart rate, and blood pressure shortly after standard induction, intubation, and caudal block. The images are a subcostal, four-chamber view of the heart obtained shortly after the initiation of resuscitation. There are copious air bubbles giving a snowstorm appearance to the right ventricle (RV) (panel A). The mitral valve, left atrium (LA), and right atrium (RA) are obscured by acoustic shadowing.
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