A 69-year-old pipe smoker with a history of cardiac disease and atrial rhythm disturbance is scheduled for a supratentorial craniotomy and is securely positioned in a semi-sitting position.Intermittent pneumatic compression devices have been placed on both legs.Pulmonary lines have been placed and the nurse has prepared an area for preparation of transesophageal electrocardiography (TEE),if needed.During the procedure,the patient reacted with a decrease in arterial pressure and end-tidal CO₂.Precordial "washing machine" sounds emanated from the Doppler.What could be the cause of his deteriorating physiologic status?

Question

Quizplus · Accepted Answer

Increased risk of an air embolism during surgery exists when the patient is in a sitting position and when a venous sinus may be breeched.A precordial Doppler ultrasound or a pulmonary artery catheter may be placed to monitor for an air embolus.A catheter in the right atrium can be used to remove an air embolus in the heart.

A 69-Year-Old Pipe Smoker with a History of Cardiac Disease