injuries poisoning
Arterial Gas Embolism
Diagnosis of Arterial Gas Embolism
Clinical evaluation Rarely, confirmation by imaging Diagnosis is primarily clinical. A high level of suspicion is necessary when divers lose consciousness during or immediately after ascent. Confirming the diagnosis is difficult because air may be reabsorbed from the affected artery before testing. Also, imaging should be used only if the diagnosis is not clear, because imaging can delay treatment. However, imaging techniques that may support the diagnosis (each with limited sensitivity and thus should not be used to exclude the diagnosis) include the following: Echocardiography (showing air in the cardiac chambers) Chest CT (showing local lung injury or hemorrhage) Head CT (showing intravascular gas and diffuse edema),although visible arterial gas is inconsistently present and its absence does not rule out arterial gas embolism Abdominal CT (showing gas within mesenteric vessels or the portal vein) Assessment should also include evaluation for other potential causes of loss of consciousness, including carbon monoxide poisoning due to contaminated breathing gas. Sometimes Decompression Sickness can cause similar symptoms and signs (for a comparison of features, see table Because decompression sickness or arterial gas embolism can be complicated by Deep Venous Thrombosis (DVT) and 