Part 8: advanced challenges in resuscitation. Section 2: toxicology in ECC. European Resuscitation Council.

Use of standard ACLS protocols for all patients who are critically poisoned may not result in an optimal outcome. Care of severely poisoned patients can be enhanced by urgent consultation with a medical toxicologist. Alternative approaches required in severely poisoned patients include: o Higher doses than usual. o Drugs that are rarely used to treat cardiac arrest (amrinone, calcium, esmolol, glucagon, insulin, labetalol, phenylephrine, physostigmine, and sodium bicarbonate). o Heroic measures, such as prolonged CPR and use of circulatory assist devices. When resuscitation is unsuccessful, organ donation may still be an option.