I wish to add my clinical observation of the beneficial effects of magnesium to the article by Shechter et al that appeared in the November issue of the Archives.1
Magnesium sulfate, in a 2-g bolus form, recently converted an elderly female patient from EMD to sinus rhythm with a pulse and blood pressure. She died several hours later in the intensive care unit. Prior to the use of magnesium sulfate, the Advanced Cardiac Life Support EMD protocol was followed. The mechanism that explains magnesium action in EMD is unclear. In future cases of EMD, a bolus of magnesium sulfate will be given earlier into the cardiac arrest to test the validity of this observation.
Forester D. Magnesium Effect in Electromechanical Dissociation (EMD). Arch Intern Med. 1993;153(10):1271. doi:10.1001/archinte.1993.00410100091018