Here’s all the key details, dosage, and additional notes on lidocaine you’ll need to know in order to pass your ACLS exam.
Lidocaine is one of several ACLS drugs used to treat cardiac arrest from ventricular tachycardia (VT) and Ventricular Fibrillation (VF). Lidocaine is considered a second-line antiarrhythmic drug and should be administered in VF/VT cases where amiodarone is either unavailable or ineffective. While lidocaine is a well-known and established ACLS medication, there is actually no proven short-term or long-term effectiveness following cardiac arrest. Therefore, use is not recommended routinely after cardiac arrest, but rather should be considered following ROSC.
When used to treat cardiac arrest from VT/VF, the initial dose should be 1-1.5 mg/kg IV/IO.
For refractory VF, an additional 0.5-0.75 mg/kg IV push may be given, then repeated every 5-10 minutes, with a max of 3 doses or a total of 3 mg/kg.
In stable VT situations, doses spanning between 0.5-0.75 mg/kg up to 1.5 mg/kg may be administered. Repeat 0.5-0.75 mg/kg to a max of 3 mg/kg.
If maintenance infusion is needed, administer a dose of 1-4 mg/min.
Additional Notes on Lidocaine Usage:
- Prophylactic use in acute myocardial infarction contraindicated
- Reduce maintenance doses when there are signs of left ventricular dysfunction or impaired liver function
- If signs of toxicity materialize, immediately cease lidocaine infusion
For a brief review of all the ACLS medications you should be familiar with, check out this short video. It acts as a great visual reference that will help you study more efficiently and effectively. If you are interested in obtaining your ACLS Certification or Recertification online, click the button below in order to learn more!
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