Hypermagnesemia in Emergency Medicine Treatment & Management

Updated: Jun 23, 2022
  • Author: Nona P Novello, MD; Chief Editor: Erik D Schraga, MD  more...
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Emergency Department Care

Although the effectiveness of dialysis in removing divalent cations is debated, some studies have demonstrated removal of a large amount of magnesium using this modality. Dialysis is best used when levels exceed 8 mEq/L, when life-threatening symptoms are present, or in patients with poor renal function.

  • Assess the patient's ABCs and stabilize.

  • Intubate if necessary.

  • Treat hypotension with fluids.

  • Treat arrhythmia as per advanced cardiac life support (ACLS) protocol or with treatment outlined below, if hypermagnesemia is known.

  • Obtain appropriate studies as discussed in Workup.

Consider transfer if a patient with renal failure has a severe elevation of magnesium and no dialysis is available.



Obtain a renal consultation for dialysis if the patient is severely hypermagnesemic.

Arrange ICU monitoring if the symptoms are severe.