In the event of a venous air embolism during a central line procedure, which immediate action is recommended?

• A. Administer 100% oxygen
• B. Clamp tubing and place patient in Trendelenburg
• C. Call the physician
• D. Raise the head of the bed

Answer: (B)

Venous air embolism during a central line is an urgent, life-threatening event where air can travel to the right heart and lungs. The priority is to stop more air from entering the circulation and prevent it from reaching the lungs. Clamping the catheter tubing at the insertion site immediately stops the source of air. Placing the patient in Trendelenburg, ideally with a left lateral tilt, helps keep any air in the right atrium and away from the pulmonary circulation, reducing the risk of a large pulmonary embolism. After securing the source and positioning, give 100% oxygen to promote rapid absorption of the air and improve oxygenation, and notify the physician for further management, which may include hyperbaric therapy if indicated. Raising the head of the bed is not helpful and can worsen the embolism.