Emergency and critical care: venous air embolism position: practice question

A General Medicine 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.

Try it

General Medicine · Emergency and critical care: venous air embolism position

Sample item

While a central venous catheter is being removed from the neck of a sitting patient, he suddenly develops breathlessness and hypotension, and a churning mill-wheel murmur is heard over the precordium. Which position should he be placed in immediately?

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

The answer and the reasoning

B. Left lateral with head down

Venous air embolism can obstruct right ventricular outflow. Placing the patient in the left lateral decubitus position with the head down (Durant manoeuvre) traps air in the apex of the right ventricle, away from the outflow tract. Give 100 percent oxygen and consider aspiration through a central line.

Option by option

  • A. Right lateral with head down

    The right lateral position lets air pass towards the outflow tract.

  • B. Left lateral with head down (correct)

    Correct. The left lateral head-down position keeps air away from the pulmonary outflow.

  • C. Sitting upright

    Sitting upright favours entry of more air and does not help.

  • D. Supine with legs raised

    Raising the legs does not stop air blocking the right ventricular outflow.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Left lateral with head down. Venous air embolism can obstruct right ventricular outflow.

Why is "Right lateral with head down" not the answer?

The right lateral position lets air pass towards the outflow tract.

Why is "Sitting upright" not the answer?

Sitting upright favours entry of more air and does not help.

Why is "Supine with legs raised" not the answer?

Raising the legs does not stop air blocking the right ventricular outflow.

What concept does this question test?

It tests Emergency and critical care: venous air embolism position in General Medicine. Placing the patient in the left lateral decubitus position with the head down (Durant manoeuvre) traps air in the apex of the right ventricle, away from the outflow tract. Give 100 percent oxygen and consider aspiration through a central line.

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 Emergency and critical care: venous air embolism position?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.