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I was taught in the adult world that it took at least 3 feet of IV tubing full of air to cause an air embolism and this had to be pushed in rapidly.  I find it hard to believe that an equivalent dose of air in a 6 week old was actually missed in the tubing?!Mike Falk, MD.

--- On Tue, 4/13/10, Todd Zimmerman <[log in to unmask]> wrote:

From: Todd Zimmerman <[log in to unmask]>
Subject: Re: Air Embolism?
To: [log in to unmask]
Date: Tuesday, April 13, 2010, 11:40 PM

Follow up email noted that this event happened well after the IV was put in, &nbsp;and right after IVF started&nbsp;infusing...pt. was not crying...


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On Apr 13, 2010 9:15 PM, Willwerth, Ben &lt;[log in to unmask]&gt; wrote: 

Hi

I would wonder about a breath holding spell. I know the kiddo would be very young for this, but I have seen it with 2 mo vaccines.



Ben Willwerth MD

former ED staff at Children's Boston, now regular old pediatrician



________________________________________

From: Pediatric Emergency Medicine Discussion List [[log in to unmask]] On Behalf Of [log in to unmask] [[log in to unmask]]

Sent: Tuesday, April 13, 2010 8:39 PM

To: [log in to unmask]

Subject: Air Embolism?



I recently got a call from one of the Peds ED's in which I am the  medical

director for that had a 6 week old there for a routine Bili work up ( if

there is such a thing :) )...

Apparently an IV was started and almost immediately, the pt. reported to

become agitated, became hypoxic, and than had a brief seizure. The pt.

recovered shortly after bagging for a very brief time...the pt. came back to

"normal" with NL VS and neuro exam within a minute or so... O2 sat recovered

immediately, HR never dipped.

Only thing that came to my mind was an air embolism.



Any other thoughts.



Pt.s blood work was nl, a head CT showed "CSF space slightly more enlarged

on the left side, no shift, no mass effect".



Dr. Todd Zimmerman



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