An air embolism can occur:
(1) during insertion of an intravascular catheter
(2) during manipulation of the catheter
(3) if a connector in the fluid line becomes loose or disconnects, allowing an air leak
(4) if the catheter or a connector is damaged or fractured
(5) during or after removing the catheter (see Central Venous Catheter (CVC) Removal Distress Syndrome, above)
Factors increasing the risk of a clinically significant air embolism:
(1) large diameter catheter and/or opening
(2) longer duration with exposure to air
(3) increased pressure differential between outside air and entry point into the vascular system
(3a) manipulating a central venous line inserted into the jugular or subclavian vein with the person sitting up
(3b) deep inspiration or cough by the patient
(3c) pressure infusion system
(3d) high pressure environment
(3e) low central venous pressure (due to shock, dehydration, etc)
(4) failure to occlude the site of a failed catheter insertion or a removed catheter
(5) failure to ensure secure connections in an infusion system
