Magnesium Sulfate in EMS || A Super Electrolyte

💊 Magnesium Sulfate 💊

Magnesium is not only an electrolyte vital in the human body, but also a useful medication EMS providers administer for multiple emergency situations.  

🫀 Magnesium Sulfate: Why do we use it? 💉 

Magnesium sulfate, aka "mag sulfate," decreases acetylcholine release and promotes the movement of other electrolytes in and out of the cells. This induces vasodilation and smooth muscle relaxation. 💪🏻

Let’s talk about the indications! 

🧠 Managing Eclampsia: Stop Mom’s Seizures! 🤰

One of the telltale signs of preeclampsia & eclampsia is hypertension. *It is important to note the only symptom separating the two conditions is the onset of seizures* Magnesium sulfate is a potent CNS depressant with significant vasodilatory effects. The effects of this medication are fantastic for both situations, but let’s point out why! In the treatment of eclampsia, bringing the blood pressure down and calming neuronal excitability is key to putting a stop to those seizures. And in the case of preeclampsia……Well, we simply want to prevent it from turning into eclampsia.

Also, don’t forget if a benzodiazepine has proven ineffective for a seizure patient (without eclampsia), magnesium sulfate can be considered as a second-line anticonvulsant.

 🧑‍🍼Managing Preterm Labor: Hang on Baby, Not Yet!🤰

Magnesium sulfate is commonly administered for preterm labor. It induces uterine smooth muscle relaxation, which slows or stops contractions. It is not typically given in the 911 EMS setting as each situation is different and the mother & baby need to be evaluated. 

🫁 Help Me Breathe: Asthma Attacks/COPD Exacerbation/Bronchospasms 🌬️

There are times when we try everything we can for our patients during the course of a COPD exacerbation (or bronchospasm) call and it just isn’t working. Magnesium sulfate is a game-changer in these cases because it induces bronchial smooth muscle relaxation.

🫀Fix My Heart: Torsades de Pointes ⚡️ 

Magnesium sulfate works to stabilize the membranes of heart muscle cells and helps the movement of other electrolytes across these cell membranes. The chance of afterpolarizations that lead to Torsades de Pointes is decreased. 

💉 The dose is typically between 1-4 gms depending on the indication, protocol and scope of practice. 💊

🚨Although it is not a medication you administer every day, it is ideally a must-have on every ambulance! 🚑