Patients who are comatose, hypotensive, or have seizures or ventricular arrhythmias should be treated in the conventional manner. Avoid sympathomimetics or catecholamines or use them with caution. Beta-blockers may be more effective than lidocaine in cases of prolonged or resistant arrhythmias.
Monitor fluid and electrolyte status carefully. Correct hypokalemia with potassium phosphate (phosphate levels are also generally low). Hypocalcemia may occur following fluid and electrolyte replenishment. Do not administer bicarbonate therapy until potassium and calcium are adequately replaced.