What is the indication for using magnesium sulfate in Advanced Life Support (ALS)?

Magnesium sulfate is indicated in Advanced Life Support primarily for the treatment of torsades de pointes and hypomagnesaemia during cardiac arrest. Torsades de pointes is a specific type of polymorphic ventricular tachycardia that is associated with a prolonged QT interval, and magnesium sulfate is effective in stabilizing the cardiac membrane and restoring normal rhythm.

In cases of hypomagnesaemia—often related to low magnesium levels in the body—administration of magnesium sulfate can correct the electrolyte imbalance which may lead to arrhythmias. During cardiac arrest situations, addressing these underlying causes is crucial for restoring effective circulation and improving patient outcomes.

While magnesium sulfate can have uses in other clinical scenarios, such as severe asthma exacerbations or eclampsia in obstetrics, these contexts are not specifically relevant in the setting of Advanced Life Support or cardiac arrest situations, which focus on immediate treatment of life-threatening arrhythmias like torsades de pointes.