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Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

Cardiopulmonary Resuscitation II: ACLS Airway Management

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Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen01:16

Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen

Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Endotracheal Tube Extubation01:24

Endotracheal Tube Extubation

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Endotracheal Intubation I: Procedure01:15

Endotracheal Intubation I: Procedure

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Endotracheal Intubation II: Nursing Management01:17

Endotracheal Intubation II: Nursing Management

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Related Experiment Video

Updated: Jul 15, 2026

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
07:15

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation

Published on: December 5, 2025

A pause before connecting insufflation tubing to decrease the risk of air embolism.

Alex I Halpern1,2, Daragh Crowley3, Lowell A Lobo3

  • 1Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, 111 Michigan Avenue NW, Washington, DC, 20010, USA. ahalpern@childrensnational.org.

Surgical Endoscopy
|July 13, 2026
PubMed
Summary

To prevent air embolism during laparoscopic surgery, wait at least ten seconds after initiating carbon dioxide (CO2) flow before connecting insufflation tubing. This simple pause ensures no ambient air enters the vascular system, making air embolism a preventable event.

Keywords:
Air embolismInsufflationLaparoscopyPatient safetyPediatrics

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The Rigid Tube as an Alternative in Controlling the Problematic Airway
08:26

The Rigid Tube as an Alternative in Controlling the Problematic Airway

Published on: June 6, 2020

Area of Science:

  • Minimally invasive surgery
  • Surgical safety
  • Anesthesiology

Background:

  • Air embolism is a rare but potentially fatal complication during laparoscopic surgery, particularly in pediatric patients.
  • A common theory suggests ambient air in insufflation tubing enters the vascular system during trocar or Veress needle insertion.
  • Current practice lacks guidelines for a delay between initiating CO2 flow and connecting tubing.

Purpose of the Study:

  • To assess the time required for CO2 to reach the end of laparoscopic insufflation tubing at various flow rates and pressures.
  • To determine if a delay in connecting tubing after initiating CO2 flow can prevent air embolism.

Main Methods:

  • Standard laparoscopic insufflation tubing was connected to an insufflator and an end-tidal CO2 monitor.
  • The time from initiating CO2 flow to a visible increase on the CO2 monitor was measured at different flow rates and pressures.
  • Each test was repeated 10 times at each setting.

Main Results:

  • The time for CO2 to reach the tubing's end ranged from 3.32 ± 0.27s to 3.46 ± 0.10s across clinically relevant settings.
  • Minimal variation in timing was observed across different flow rates and pressures.
  • This suggests a consistent delay before CO2 fully purges the tubing.

Conclusions:

  • A waiting period of at least ten seconds is recommended between initiating CO2 flow and connecting the insufflation tubing.
  • This delay ensures the absence of ambient air in the tubing, preventing air embolism.
  • Adhering to this guideline can make air embolism a 'never event' in laparoscopic procedures.