If there is air in the extracorporeal circuit during dialysis and the nurse is being summoned, in which position should the patient be placed?

• A. Trendelenburg position on the left side
• B. Supine with legs elevated
• C. Left lateral decubitus without Trendelenburg
• D. Upright seated position

Answer: (A)

When air enters the extracorporeal circuit, the immediate goal is to keep any entrained air from reaching the brain or lungs. Positioning the patient in Trendelenburg (head-down) and on the left side helps trap the air in the right atrium and ventricle, away from the pulmonary outflow and cerebral circulation. This left Trendelenburg posture directs the circulating air toward the right heart, where it’s less likely to cause cerebral or pulmonary embolism, giving time to remove the air and stabilize the patient. In contrast, other positions don’t offer the same protection against air embolism and can allow air to migrate toward critical organs.