Circulation
In theophylline and caffeine poisoning, start intravenous fluids in all patients, as vomiting is common. If dehydration and hypotension are problematic, first-line treatment intravenous fluid resuscitation. If hypotension persists, start vasopressor support. Vasopressors with selective alpha-agonist activity are recommended. Use:
metaraminol 0.5 to 1 mg (child: 0.01 mg/kg) intravenously theophylline and caffeine poisonings
FOLLOWED BY
noradrenaline (norepinephrine) by intravenous infusion (see Noradrenaline (norepinephrine) intravenous infusion instructions for advice on preparation and administration). theophylline and caffeine poisonings
Discuss the use of other vasopressors or beta blockers with a clinical toxicologist.
Ventricular tachycardia and ventricular fibrillation are rare. For cardiorespiratory arrest and life-threatening arrhythmias, follow advanced life support protocols1 and seek advice from a clinical toxicologist.