Which medication is used in crush injuries to help prevent ventricular fibrillation?

Which medication is used in crush injuries to help prevent ventricular fibrillation?

• A. Calcium Gluconate IV (1 g, 10%, 10 mL)
• B. Potassium chloride
• C. Normal Saline
• D. Epinephrine

Answer: (A)

Crush injuries can dump potassium from damaged muscle into the bloodstream, creating hyperkalemia that can trigger dangerous heart rhythms like ventricular fibrillation. Calcium gluconate given IV stabilizes the heart muscle membranes, raising the threshold for depolarization and reducing the myocardium’s vulnerability to the high potassium environment. This membrane stabilization buys time for treatments that actually lower potassium (such as insulin with glucose, bicarbonate, beta-agonists, and eventual dialysis) and for aggressive fluid resuscitation to protect kidney function. The other options don’t provide this immediate protective effect on the cardiac cells: raising potassium would worsen the problem, while fluids or epinephrine don’t prevent hyperkalemia-driven VF.

Crush injuries can dump potassium from damaged muscle into the bloodstream, creating hyperkalemia that can trigger dangerous heart rhythms like ventricular fibrillation. Calcium gluconate given IV stabilizes the heart muscle membranes, raising the threshold for depolarization and reducing the myocardium’s vulnerability to the high potassium environment. This membrane stabilization buys time for treatments that actually lower potassium (such as insulin with glucose, bicarbonate, beta-agonists, and eventual dialysis) and for aggressive fluid resuscitation to protect kidney function. The other options don’t provide this immediate protective effect on the cardiac cells: raising potassium would worsen the problem, while fluids or epinephrine don’t prevent hyperkalemia-driven VF.