What is the treatment for sudden worsening of TOF?

Ans. is 'd' i.e., All of the above * Sudden worsening ofTOF - known as 'Cyanotic spelV* Therapy is aimed at providing an immediate increase in pulmonary blood flow to prevent the sequelae of severe hypoxia.* Management consists of:i) Knee chest positionii) Humidified oxygeniii) Hydration - Prevention or prompt treatment of dehydration is important to avoid hemoconcentration and possible thrombotic episodes.iv) Prostaglandin El - Dilatation of ductus arteriosus and provides adequate pulmonary blood flow. This agent should be administered intravenously as soon as cyanotic congenital heart disease is clinically suspected and continued through the preoperative period and during cardiac catheterization.v) Morphine 0.1 to 0.2 mg/kg subcutaneous inj.vi) Correction of acidosis with sodium bicarbonate IV.vii) Propranolol: 0.5 - 1 mg/kg/IV - to decrease the frequency and severity of hypercyanotic spells, but with the excellent surgical results available today, surgical treatment is now indicated as soon as spells begin.viii) Vasopressors: Methoxamine or phenylephrine.ix) Correction of Anaemia.