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Prophylactic intravenous magnesium post successful resuscitation from VF or pulseless VT arrest

Three Part Question

[In a patient post VF or pulseless VT arrest] [should IV magnesium be given to prevent a further episode of VF or pulseless VT] or [should iv magnesium purely be used if magnesium levels are below normal range or the rhythm was torsades de pointes]?

Clinical Scenario

You have just successfully defibrillated a 66 year old man who attended the ED with chest pain and suffered a VF arrest. He is maintaining his own airway,and starting to speak, with BP 159/77. His ECG shows an anterior MI and multiple ectopics. You are concerned he will suffer another pulseless arrthythmia and wonder whether prophylactic loading with magnesium would be useful. Your consultant says you should wait for his levels before commencing the infusion as this was not a torsades de pointes. You wonder if there is any evidence that magnesium would be beneficial here.

Search Strategy

OVID Medline 1950 - October Week 1 2009