Why should air not be used to identify the epidural space in children?

Why should air not be used to identify the epidural space in children?

• A. Venous air embolism
• B. Infection
• C. Epidural hematoma
• D. Subcutaneous emphysema

Answer: (A)

Using air to identify the epidural space introduces air into the epidural venous plexus, and in children the epidural veins are relatively prominent within a smaller spinal canal. This makes it easier for even small amounts of air to be entrained into the venous system and travel to the heart and lungs, causing a venous air embolism. Using saline avoids introducing free air into the circulation, reducing this serious risk. The other issues listed are not specifically tied to the use of air for loss of resistance, whereas venous air embolism is the principal concern in pediatric patients.

Using air to identify the epidural space introduces air into the epidural venous plexus, and in children the epidural veins are relatively prominent within a smaller spinal canal. This makes it easier for even small amounts of air to be entrained into the venous system and travel to the heart and lungs, causing a venous air embolism. Using saline avoids introducing free air into the circulation, reducing this serious risk. The other issues listed are not specifically tied to the use of air for loss of resistance, whereas venous air embolism is the principal concern in pediatric patients.