Systemic fibrinolysis through intraosseous vascular access in ST-segment elevation myocardial infarction.
In emergency situations, intraosseous cannulation represents an alternative route of vascular access when peripheral vein insertion is difficult. We present the first documented case of intraosseous systemic fibrinolysis in a patient with ST-segment elevation myocardial infarction. In this case, repetitive episodes of ventricular fibrillation occurred soon after first contact with emergency care providers. Given that the patient had difficult peripheral venous access, an intraosseous catheter was inserted. Fibrinolytics and antiarrhythmic drugs were administered though this line, resulting in resolution of coronary ischemia and electrical instability, without complications. Intraosseous cannulation represents a novel route for administration of systemic fibrinolysis in cases of difficult peripheral venous access in the out-of-hospital setting.
Servicio de Asistencia Municipal de Urgencia y Rescate, Madrid, Spain.
Pedro José
PJ
Ruiz-Hornillos
Fernando
F
Martínez-Cámara
Mercedes
M
Elizondo
José Antonio
JA
Jiménez-Fraile
Maria
M
Del Mar Alonso-Sánchez
Dolores
D
Galán
Juan Carlos
JC
García-Rubira
Carlos
C
Macaya
Borja
B
Ibanez
D004562:Electrocardiography; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D017148:Infusions, Intraosseous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D000077785:Tenecteplase; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase