Between the New Years holiday, conference, and sick call, this is the first pearl of the new year. I will make up the missed pearls with board review questions this weekend!
Dr. Strayer’s case:
48 yo M known alcoholic presents to the ED s/p sz, is tremulous and vomiting. EKG is as follows:
What medication are you going to give him and what medication are you going to avoid?
Pt has a prolonged QT, Magnesium level was 0.7. Pt is at risk of decompensating into Torsade de Pointes
You would give this patient IV magnesium
You would refrain from giving Zofran for the vomiting as it has the potential to further prolong the QT .
** be sure to check and correct Ca and K as well
for some more interesting vignettes about possible presentations and management of prolonged QT go to: