Sodium channel blocker arrest — DipIMC MCQ
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Correct answer: A — Give sodium bicarbonate according to local toxicology or resuscitation guidance
Give sodium bicarbonate according to local toxicology or resuscitation guidance is the best answer because tricyclic overdose with broad complexes is a recognised indication for sodium bicarbonate during resuscitation. Delay drug delivery until hospital arrival is less appropriate because ALS drugs are part of established resuscitation when indicated; Give atropine routinely during asystolic arrest is less appropriate because atropine is not routine adult ALS cardiac arrest therapy. Give amiodarone before attempting defibrillation and Give sodium bicarbonate routinely in every arrest are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.
Reference: Resuscitation Council UK Guidelines; TOXBASE/NPIS guidance; JRCALC Guidelines