Circulation

Treatment for hypotension

Most patients with acute arsenic poisoning require intravenous fluid resuscitation because of dehydration, large gastrointestinal fluid losses and hypotension. In severe poisoning, hypotension can be compounded by arsenic-induced myocardial depression and peripheral vasodilation.

If hypotension is refractory to intravenous fluids, start inotropic support.

Treatment for QT-interval prolongation and torsades de pointes

If there is evidence of QT-interval prolongation on ECG due to arsenic poisoning, commence continuous ECG monitoring and assess 6-hourly 12-lead ECGs for at least 24 hours and until the QT interval normalises. Manage urgently according to Treatment for QT-interval prolongation and torsades de pointes.