- Management of Sodium Channel and Beta Adrenoceptor block required
- Call for Help and Commence CPR – need a large team as CPR can be prolonged
- Boluses of IV Sodium Bicarbonate 100mmol (100ml 8.4%)
- Intubate and (hyper)Ventilate
- Adrenaline as per ALS protocol
- Glucagon 5-10mg IV bolus, commencing infusion if improvement seen
- High Dose Euglycaemic Insulin Therapy
- Intralipid can be used for refractory cases
After successful return of cardiac output, Central Vascular access gained and commenced vasopressors and RRT for profound persistent metabolic acidosis . Activated Charcoal given via NG.
