Magnesium for torsades

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Specializes in CVICU, ER.

How fast do you administer 2 grams Magnesium for Torsades? I've had MDs tell me to push it in fast, but I looked it up, and its supposed to be over 15 minutes minimum. How do you do it?

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Specializes in ICU, MICU, SICU.

Push! The patient is dying.

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Specializes in CVICU, ER.

Good point :) But can't you send them into V-fib?

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Specializes in ICU, ER, EP,.

torsades is not a rhythm of life. It is chaotic ventricular movement prior to death. Consider the patient dead and you push the Magnesium, just like epi and atropine.... closest line to the heart, pushed fast with a flush.

torsades is a pre vfib, which gives you a few moments of a grace period to push a drug before shocking a death rhythm, nothing else. I hope that helps.

I'm also assuming this patient had no AICD, because with those buggers, some times you need to wait it out 40 seconds or so and just prepare and wait a very long 60 seconds :) Assuming ICU with monitoring. The AICD's will shock that quickly at some point when it get's a touch finer so be prepared.

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Specializes in ER, Trauma.

Should we differentiate between a patient in Torsades or one that has resolved from torsades?

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I remember this quote from a nurse's blog I used to read, "Push it as fast as you want, the patient's dead". Now if they weren't dead, then 15+ min is the speed. (Can't help but say, "I'm not dead yet" in my head)

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i just gave mag for torsades, if it premixed in a bag run in it wide open , or push it as fast as you like, you can run it slower for respiratory issues

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