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American Society for Reproductive Medicine (2023)

prophylaxis has not been show to reduce amputation [16] Administration is based on clinical judgement Prehospital thrombolysis In hospital tissue plasminogen activator [rTPA]) has resulted in reduced amputation rates Effectiveness and use appears to be time dependent, similar to other vascular lesions in which thrombolysis is indicated [17] Two case studies describe successful use of thrombolysis at K2 basecamp (need citations) Currently there are no clear guidelines to recommend prehospital thrombolysis Iloprost Has been used in community hospitals in Canada [18] Role in prehospital treatment has not been delineated Sympathetic blockade/ Regional anesthesia A single case report describes prehospital wrist block with good effect [19] Can not currently be recommended based on the available evidence

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