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Gas embolism following intraosseous medication application proven by post-mortem multislice computed tomography and
Elke Hillewig1, Emin Aghayev, Christian Jackowski
1Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland.
Abstract:
The post-mortem use of modern imaging techniques such as multislice computed tomography (MSCT) is becoming increasingly important as an aid for conventional autopsy. This article presents a case of a 4-month-old boy who died from sudden infant death syndrome (SIDS) with intravascular gas after an intraosseus medication application documented by post-mortem MSCT. It is most likely that the gas entered the body during resuscitation. This case emphasises the advantage of post-mortem imaging as a complementary aid for the autopsy. We conclude that during emergency treatment, the medical staff should be aware of the possibility of causing a gas embolism following intraosseus medication. Resuscitation with an inserted, disconnected intraosseous needle should be avoided.
Insights
Post-mortem multislice computed tomography (MSCT) aided autopsy in a sudden infant death syndrome (SIDS) case. Gas embolism from intraosseous medication during resuscitation was identified, highlighting imaging
Area of Science:
- Forensic Pathology
- Medical Imaging
- Pediatric Medicine
Background:
- Conventional autopsy is crucial for determining cause of death.
- Modern imaging techniques like multislice computed tomography (MSCT) are increasingly used as adjuncts to autopsy.
- Sudden Infant Death Syndrome (SIDS) remains a significant concern in pediatric mortality.
Observation:
- A case study involving a 4-month-old boy who died from SIDS.
- Post-mortem MSCT revealed intravascular gas, linked to intraosseous medication administration.
- The gas was likely introduced during resuscitation efforts.
Findings:
- Post-mortem MSCT effectively documented intravascular gas embolism.
- The gas embolism was associated with intraosseous medication application.
- The findings suggest gas entered the vasculature during resuscitation.
Implications:
- Post-mortem imaging serves as a valuable complementary tool for autopsy.
- Medical professionals must recognize the risk of gas embolism from intraosseous medication.
- Avoid resuscitation procedures involving disconnected intraosseous needles to prevent complications.
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