Complications: venous air embolism: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Complications: venous air embolism

Sample item

A patient in the sitting position for posterior fossa surgery develops sudden hypotension, a sharp fall in end-tidal CO2 and a mill-wheel murmur. What should be done?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Flood the field with saline, lower the head, aspirate the right atrial catheter and give 100% oxygen

Venous air embolism is managed by stopping air entry (flooding the field, bone wax), positioning the head down, aspirating air through a right atrial catheter, stopping nitrous oxide and giving 100% oxygen. Precordial Doppler is the most sensitive detector.

Option by option

  • A. Give dobutamine only

    Inotrope alone does not remove the air.

  • B. Flood the field with saline, lower the head, aspirate the right atrial catheter and give 100% oxygen (correct)

    Correct. These measures stop entry and remove air.

  • C. Raise the patient's head further

    Raising the head worsens air entry.

  • D. Increase nitrous oxide

    Nitrous oxide expands the bubbles.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Flood the field with saline, lower the head, aspirate the right atrial catheter and give 100% oxygen. Venous air embolism is managed by stopping air entry (flooding the field, bone wax), positioning the head down, aspirating air through a right atrial catheter, stopping nitrous oxide and giving 100% oxygen.

Why is "Give dobutamine only" not the answer?

Inotrope alone does not remove the air.

Why is "Raise the patient's head further" not the answer?

Raising the head worsens air entry.

Why is "Increase nitrous oxide" not the answer?

Nitrous oxide expands the bubbles.

What concept does this question test?

It tests Complications: venous air embolism in Anaesthesia. Precordial Doppler is the most sensitive detector.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications: venous air embolism?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.