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A quality review of the occurrence of a non-fatal venous air embolism event following CT contrast enhanced administration for the purpose of radiation therapy planning

Abstract Background The incidence of venous air embolism (VAE) during and following diagnostic and interventional radiographic procedures utilizing contrast media has been well documented in the literature. However to date a case report of a venous air embolism occurring within an outpatient healthcare facility during a contrast enhanced computer tomography radiation therapy planning procedure remains under reported. Purpose Healthcare professionals must remain alerted to the fact that iatrogenic VAE may occur unexpectedly during and following diagnostic and interventional radiographic procedures utilizing the injection of contrast media. The action by all healthcare professionals to implement rapid and clear acute care guidelines will increase the probability of the patient recovering from the event. Materials and methods A review of the aetiology and associated pathophysiology of VAE is provided. This is followed by a detailed case report of the occurrence of a non-fatal VAE event (patient consent was obtained and the consent form template was reviewed by a Research Ethics Board). Conclusion We conclude with a discussion of quality assurance recommendations that should be considered for implementation in an outpatient facility setting that is performing contrast enhanced computer tomography diagnostic, interventional or radiation therapy planning radiographic procedures.