Air may enter the catheter if it becomes disconnected while unclamped. During inspiration, intra-thoracic pressure decreases relative to atmospheric pressure, thus facilitating travel of an air embolus from high pressure (atmosphere) to low pressure (intra-thoracic).  Prevention is key!

1. Ensure an injection cap is attached to each lumen of the central venous catheter
2. Ensure all connections are securely luer-locked
3. Clamp the catheter when opening the system
4. Ensure that any air within the injection site cap/catheter has been withdrawn prior to injecting any fluid
5. Never use scissors to remove the dressing
6. If the line becomes disconnected, clamp proximal to the damage. Attach a 10mL syringe to remove air that may have entered the catheter
7. The catheter may be repaired with a special kit specific for type and size of the long-term central venous catheter, which can be obtained from the OR.
8. In case of an air embolus:

• Turn the patient to left lateral Trendelenburg position
• Administer oxygen