Which of the following is a management step for cardiac arrest due to local anaesthetic toxicity?

Administering a 20% lipid emulsion intravenously is a key management step for patients experiencing cardiac arrest secondary to local anaesthetic toxicity. This intervention is based on the principle of lipid rescue therapy, which has been shown to effectively bind lipophilic medications, including local anaesthetics, thereby reducing their toxic effects on the heart and potentially reversing the situation.

Lipid emulsion therapy works by providing a circulating reservoir of lipids that can help sequester the local anaesthetic from its sites of action, reduce its bioavailability, and assist in restoring normal cardiac function. This approach is particularly important in cases of severe toxicity where standard resuscitation measures may be insufficient.

Other management steps for cardiac arrest, such as intubating immediately, stopping all medications, or performing chest compressions only, do not specifically address the underlying issue of local anaesthetic toxicity in the same effective manner as lipid emulsion therapy does. Instead, while maintaining airway and breathing are critical, they do not provide the direct mitigation of toxic effects offered by lipid administration.