tPA in cardiac arrest due to PE

Q: How the tPA should be given to a patient who is in cardiac arrest due to massive pulmonary embolism (PE)?


Answer:  During cardiac arrest, due to PE it is not practical to wait for standard two hours infusion. tPA is available as a 50 mg vial and an entire vial should be given as an IV bolus over two minutes. Another dose should be repeated after 15 minutes if a patient remains in cardiac arrest.

#hemodynamic
#cardiology
#pulmonary


Reference: 

Lavonas EJ, Drennan IR, Gabrielli A, et al. Part 10: Special Circumstances of Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132:S501.