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….

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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!

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      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… 😉

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      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. 🙂

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  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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