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Air Embolism Dialysis Management — ESENeph MCQ

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HardHaemodialysisAir Embolism Dialysis ManagementESENeph

A 55-year-old man on haemodialysis develops air embolism during a dialysis session. The venous line was inadvertently disconnected. He develops sudden dyspnoea, cyanosis, and cardiac arrest. What is the immediate management position?

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Correct answer: D — Place the patient in left lateral decubitus position with head down (Durant manoeuvre)

Air embolism during haemodialysis is a rare but potentially fatal complication. The immediate management is: clamp the venous line, place the patient in the left lateral decubitus head-down position (Durant manoeuvre) to trap air in the right atrium/ventricle and prevent it entering the pulmonary vasculature, administer 100% oxygen, and commence CPR if in cardiac arrest. Modern dialysis machines have air detectors that clamp the line automatically, but vigilance is still required.

Reference: ERA-EDTA 2019 – HD Safety; Resuscitation Council UK – Special Circumstances