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Potentially reversible causes of non-ventricular fibrillation/ventricular tachycardia (VF/VT)
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  1. P D Macintyre1,
  2. E L Lloyd2
  1. 1Department of Medicine and Therapeutics University of Glasgow Gardiner Institute Western Infirmary Glasgow G11 6NT United Kingdom
  2. 272 Belgrave Road Edinburgh EH12 6NQ United Kingdom

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    A useful mnemonic derived from the conditions shown in fig 1 causing a non-VF/VT cardiac arrest is the four Hs and the four Ts.

    Figure 1

    Climbers in snowhole.

    Figure 2

    Climber in spindrift.

    Hypoxia

    There are many cardiac and respiratory causes of severe hypoxia, which require emergency treatment of the underlying condition. Oxygen treatment in an appropriate dose should be administered where possible. However, it is important to exclude a mechanical cause such as upper airways obstruction or tension pneumothorax.

    Hypovolaemia

    The casualty should be inspected for evidence of haematemesis or melaena stool. Internal haemorrhage should always be suspected with evidence of penetrating wounds to the abdomen or chest.

    Hyperkalaemia/Hypokalaemia

    Elevated plasma potassium levels occur with renal failure, diabetic ketoacidosis, potassium sparing diuretics, or excessive ingestion of potassium salts. In the context of a cardiac arrest, the patient should be given intravenously 10 ml 10% …

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