Lipid emulsion therapy given intraosseously in massive verapamil overdose

Area of Science:

• Emergency Medicine
• Toxicology
• Critical Care

Background:

• Intravenous fat emulsion (IFE) is a standard treatment for various medication overdoses in the emergency department (ED).
• IFE is typically administered through peripheral or central venous access.
• Intraosseous (IO) administration of IFE in humans has not been previously reported.

Observation:

• A patient with a massive verapamil overdose required emergent treatment with vasopressors and IFE.
• Peripheral intravenous access was lost, necessitating the placement of an IO line.
• IFE therapy was initiated via the IO route using an EZ-IO system.

Findings:

• This case represents the first reported instance of intraosseous administration of intravenous fat emulsion in a human patient.
• The IO line provided a viable, albeit temporary, route for IFE delivery during a critical care scenario.
• Challenges with infusion flow through the IO line were encountered, leading to a transfer to newly established peripheral access.

Implications:

• Intraosseous administration of IFE may serve as a crucial alternative in emergencies when intravenous access is compromised.
• This case highlights the adaptability of IFE therapy in life-threatening situations.
• Further research is warranted to explore the efficacy and safety of IO IFE administration.
• Meta_The_IO_route_offers_a_potential_alternative_for_IFE_administration_in_emergencies_when_traditional_IV_access_is_limited.