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In this two-minute piece about magnesium, there are just two things that you need to remember:
- Magnesium = Magnum (gun)
- When there is magnesium, there is less excitement
To easily recall what magnesium is, you can think about it as a magnum which is a type of gun. How can we put magnesium in a magnum scenario?
When you are at a party, and someone suddenly pulls out a magnum, people would refrain from moving, jumping, and having a good time. When there’s a gun, people would usually hit the deck, the music stops, and everyone’s quiet. This is also true if applied in a scenario with a bank robbery. Basically, when there’s a magnum, the excitement stops.
Hypermagnesemia is an electrolyte imbalance wherein increased levels of magnesium are present in the blood. Therefore, bringing a gun to a party which causes everything to shut down, can be considered as hypermagnesemia.
If there is hypermagnesemia, there is increased magnesium inside the body, so there will be less cell excitability.
On the other hand, if there is decreased magnesium in the blood, lower than its standard levels, that’s hypomagnesemia. Again, back to the guns at a party; if you didn’t bring your magnum to a party, a festival, or a spring break, there’s no threat so people will be partying, dancing and singing, the music’s blaring, basically, everyone’s’ having a good time. This scenario is really not a bad thing, right?
However, if you have hypomagnesemia and you shift your perspective by relating that to what’s happening inside the body, that’s when things become dangerous. If there is a lot of excitement, like for example, in the heart, due to the increased electrical stimulant, there will be the presence of a tornado (Torsades de Pointes).
To pacify elevated excitement happening inside the heart, magnesium sulfate must be administered to the client. Magnesium sulfate is like bringing in the big guns, doing crowd control in a rally and bringing the outlaws to justice.
What are the leading indicators for infusing magnesium sulfate?
- The tornado (Torsades de Pointes) is a specific type of polymorphic ventricular tachycardia that is mainly characterized by erratic and rapid QRS complexes with a tornado-like baseline. Torsades de Pointes is seen on your EKG strip.
- Any form of irregular ventricular rhythms like ventricular fibrillation (V-fib) or ventricular tachycardia (V-tach).
- Cardioversion or in layman’s term, “Big Shock.” Here, a shock is sent through the SA node down to the AV node, then to the Purkinje fibers, and through the bundle branches to get good, clean contractions and getting the heart rhythm back on track.
A Bit of Review
Remember, when you see in your EKG strip that tornado (Torsades de Pointes), magnesium sulfate is usually given to bring down the excitability. Remember, if you have a magnum, there’s no reason to be excited about that. On the other hand, magnesium sulfate will do crowd control, bring down the excitement, and get the baseline back to normal.
So that’s your two-minute rundown of magnesium, hypo and hyper magnesium, and magnesium sulfate. Hopefully, this helped with your magnesium dilemma.
Until our next lecture!