Resuscitation (2007) 72, 149—153 CASE REPORT Gas embolism following intraosseous medication application proven by post-mortem multislice computed tomography and autopsy  Elke Hillewig a,b , Emin Aghayev a , Christian Jackowski a , Andreas Christe a,c , Thomas Plattner a , Michael J. Thali a,c,* a Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland b Institute of Forensic Medicine, University of Ghent, Jozef Kluyskensstraat 29, BE-9000 Ghent, Belgium c Institute of Diagnostic Radiology, Inselspital, CH-3010 Bern, Switzerland Received 11 January 2006; received in revised form 26 May 2006; accepted 7 June 2006 KEYWORDS Gas embolism; Resuscitation; Forensic radiology; Child; Virtopsy; Post-mortem Summary The post-mortem use of modern imaging techniques such as multislice computed tomography (MSCT) is becoming increasingly important as an aid for con- ventional 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 med- ication 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. © 2006 Elsevier Ireland Ltd. All rights reserved. Introduction The post-mortem use of multislice computed tomography (MSCT) is becoming increasingly impor- tant as an aid for conventional autopsy. 1—4 The main advantages of post-mortem imaging are observer-  A Spanish translated version of the summary of this article appears as Appendix in the final online version at doi:10.1016/j. resuscitation.2006.06.023. ∗ Corresponding author at: Institute of Forensic Medicine, Uni- versity of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland. Tel.: +41 31 631 84 12; fax: +41 31 631 38 33. E-mail address: michael.thali@irm.unibe.ch (M.J. Thali). independent documentation of the findings, data storage with the option to review a case years later and the possibility to emphasise points of interest to the forensic pathologist prior to autopsy. In the following, a case of SIDS with intravascu- lar gas due to intraosseous medication application, which was detected by post-mortem MSCT, is pre- sented. Case report A 4-month-old boy was found lifeless in his bed, lying in a prone position under his bed-sheet 0300-9572/$ — see front matter © 2006 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.resuscitation.2006.06.023