Pocket of Air

But I couldn’t have done it, could I? My mind swirled with chaotic panic, as I desperately looked through the internet, looking for any bit of information that could alleviate my fears.

I punched in key terms “lethal” and “air embolism” on Google. Definitions and the pathogenesis of air embolism were explained on various sites. Still, they didn’t provide the answers that I desperately needed. I scrolled through pages of the search results, and then bam – there it was.

Air Embolism

Reading through the article, I was immensely relieved. The panic, and the chaos in my mind instantly subsided. This article was to keep me sane, for in it, it states that it takes about 200-300 mL of air injection to kill someone. Why am I so thankful for this piece of information?

It all starts back to earlier that day. Earlier that day, I had been in ED, practicing my cannulation skills on patients that needed a cannula. It had been perhaps a good 3-4 months ago since I had inserted a cannula, and I was really rusty in my skills. On one pretty stoic gentleman, I popped the tourniquet up, producing some bulging veins. This would be easy, and I inserted and successfully advanced a cannula. Removing the needle, the plastic part stayed behind, and blood slowly trickled out of the cannula. I was happy I was in a vein. With that in mind, I grabbed my saline syringe flush. Connecting it in to the cannula, I depressed the plunger. It didn’t budge. I tried harder, and it advanced a small bit. This is certainly strange I thought to myself. So I kept on going, and probably advanced about 1-2 mL of the saline flush in, and decided to give up. That’s when I noticed there were some pockets of air in my syringe.

I started to panic. Had I given this patient an air embolus? It certainly wouldn’t kill him would it? I prayed dearly that nothing would come of it. Too scared to tell anyone, I kept a close eye on him that morning at ED. Nothing happened to him, but I was scared for my life. Thoughts raced through my mind, coroner’s reports, news reports about the negligent medical student who gave an air embolus to a patient. Maybe I should quit medical school before they find out? Maybe nothing won’t occur. Maybe….  I need some reassurance.

Reading through the internet article, I was relieved that it would take 200-300 mL of air to kill someone. It was a close call, but I like to think that the air would be reabsorbed by the patient’s body. I sincerely hope nothing bad has happened to the gentleman.

And so, such was an extremely anxious and scary learning experience, coupled with my inexperience during my student years. Yes, I dread the many more days of similar experiences of close calls that are to come as a doctor….

8 thoughts on “Pocket of Air

      1. I flushing a central line I had just placed, realizing there was a small air bubble too late. I left the procedure trying to act cool until I could go look up air embolism. Panic, panic, panic… Whew!


      2. There was only one place in that hospital to get the internet back then, in the resident call lounge. So I had to wait my turn. I couldn’t just shout, “Move over I think I killed someone!” Truly, after reading your experience I wonder if this is one of those closely guarded secret rites of passage that we all go through but never talk about… 😉


      3. Yea, from the impression I got from others, it seemed like no one else made a mistake as such, but then again, no one likes to tell others about their potentially fatal mistake. I havn’t told anyone about this incident in real life. 🙂


  1. Ditto here!! Even just last week, while sitting with my girlfriend in the ER, she had an IV started for pain meds and she saw a little air bubble in the cannula. I knew she’d be fine but it did bring back memories of my panicky episode as a med student.


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