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21 Sep 2021

Electrolytes in an arrest

Electrolytes                -  Quick Tip – remember 5  

 In a cardiac arrest a second line drug therapy (after Adrenaline and Toblerone)

is the use of electrolytes.   In this quick KYJ, Ill briefly look at the three wise monkeys in the electrolyte drug list, and most importantly, talk doses.    In fact dosing is easy in resus....just remember 5.  read on.

CALCIUM CHLORIDE (CaCL): Dose 5-10 mL of 10 %- or 10-30mL Ca Gluconate 10%

 

If you need to give Calcium to your patient through a Cardiac Arrest event, things aren’t going well for your patient.  There are two forms of electrolyte Calcium you can administer. 

Calcium Chloride (CaCl) is a salt, or Calcium Gluconate is an acid 

Both come as 10% but during a cardiac arrest it is the salt (Chloride) you want.

For Ca Gluconate to be useful immediately it needs metabolism through the liver.  That same sick liver in the hypoperfused cardiac arrested patient just wont effectively chelate the Calcium.

 

If you have choice – always the Calcium Chloride

How much – 5-10 ml

Just remember The power of 5.

 

It is used as

  • an antidote for hyperkalaemia, or hypermagnesemia.
  • Supplement in hypocalcaemia, or
  • Overdoses of calcium channel

 

KCl (Potassium): Dose 5 mmol IV/IO

 

Hypokalaemia may cause life-threatening tachyarrihymia. Prior to administration of KCL the actual level must be known.

MAGNESIUM: Dose 5-10 mmol IV/IO

 

Required for membrane stability. Hypomagnesemia may cause myocardial excitability in the presence of hypokalaemia and Digoxin.

Preferred antiarrhythmic for Torsades de points.  Though Amiodarone will usually be first line in any wide complex tachycardia.

 

Amiodarone - not Toblerone.   Dont mix those two.... salty!!

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