Things to note:- Cardioversion/defibrillation, as necessary.
- Torsades complicating bradycardia: temporary pacing.
Medical Treatment: - Stop all QT-prolonging drugs.
- Correct serum potassium
- Magnesium sulphate, IV, 2 g administered over 5-10 minutes.
If recurrent episodes after initial dose of magnesium sulphate:
- Magnesium sulphate, IV, 2 g administered over 24 hours.
Torsades complicating bradycardia:
- Adrenaline infusion to raise heart rate to > 100/ minute (if temporary pacing unavailable).
When to refer:- All cases of wide QRS tachycardia, after resuscitation and stabilization.