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- Administer intravenous propranolol
- Prepare to assist with cardiac defibrillation
- Administer intravenous procainamide
- Assist with external cardiac pacing
- Administer intravenous magnesium sulfate
Torsades de pointes is a potentially life-threatening condition that develops after a noted prolonged Q-T interval as seen on an ECG. This type of arrhythmia typically requires cardiac defibrillation to correct the condition. It is considered a medical emergency that requires rapid response. Magnesium sulfate is the first line medication given, 1-2g over 30-60 seconds. Propranolol is a beta blocker that can be used for long term management of Torsades de pointes but would not be a first line drug given during the event. Procainamide can cause Torsades and is not a treatment for it. You can shock/defibrillate Torsades, but you won't be doing external pacing.
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