Management of cardiorespiratory arrest due to poisoning
Cardiorespiratory arrest due to poisoning most commonly occurs early after the exposure, when peak serum drug or toxin concentrations are reached before redistribution.
Follow advanced life support protocols for cardiorespiratory arrest1.
Prolonged cardiopulmonary resuscitation (CPR) is essential for managing cardiorespiratory arrest due to poisoning. Unlike patients in cardiorespiratory arrest due to cardiovascular disease, patients with poisoning are usually healthy before the exposure, and the toxic effects are likely to be reversible. Prolonged CPR enables rapid redistribution of toxins, and allows time for other interventions to be effective. In patients with poisoning, survival and preservation of normal neurological function after hours of CPR is well established. Consider extracorporeal membrane oxygenation (ECMO), if available, for refractory cardiorespiratory arrest in consultation with a clinical toxicologist. Continue CPR and ECMO until advice from a clinical toxicologist has been sought.