Antidote:: benzos **beta blockers contraindicated** → unopposed alpha causes: - placental abruption - prematurity - status epilepticus - CVA/ICH - MI - coronary vasospasm - rhabdomyolysis # Management of specific issues | issue | drug | | ----------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | delirium / agitation | - diazepam 5-10mg IV Q5-10 min<br>- oral diaz Q 30 min<br>- droperidol 10mg IV/IM if severe | | seizures | - IV benzos eg [[midazolam]] | | HTN | - benzos<br>- *phentolamine 1mg IV Q5 min*<br>- [[GTN]] infusion<br>- [[sodium nitroprusside]] infusion<br>+/- hydralazine 10-20mg<br>+/- clonidine 0.1-0.3 po Q12h | | [[Heat-related illness\|hyperthermia]] <br>> 38.5 deg | - IV cooled fluids<br>- beonos <br>- paralysis and ventilation if severe eg temp > 39.5 deg | | [[ACS]] | - PCI<br>- risks of thrombolysis due to intracranial haemorrhage and aortic dissection | | SVT | - diazepam / midazolam<br>- IV verapamil 1-2mg IV Q 1-2 min max 10 mg | | [[Ventricular Tachycardia\|VT]] / VF | - 100 mg IV [[HCO3 therapy\|sodium bicarb]] (1 mL/kg 8.4% slow push) Q5 min<br>- cardioversion / defibrillation<br>- *lignocaine* may be effective (noting this is a class Ib sodium channel blocker) 1.5mg/kg IV slow bolus then 2mg/min infusion <br>- d/w toxicology |