International Pain and Spine Intervention Society Emergency Protocols: Intra-arterial Injection.

This protocol discusses the risks associated with inadvertent intra-arterial injection during spine interventions, including stroke, seizure, spinal cord infarction, and paralysis. It highlights the dangers of particulate steroid embolism and arterial vasospasm, particularly during transforaminal injections. The protocol focuses on immediate recognition, termination of the procedure, activating stroke protocols, neurologic assessment, airway management, and rapid transfer for advanced neurologic care.