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EMR
EMT
AEMT
Paramedic
Extended
Lidocaine
Action
Onset
Anti-arrhythmic
Sodium Channel Blocker
30-90 seconds
Indications
Vfib / Pulseless Vtach (Adult and Ped)
RSI
Adult Dose
Cardiac Arrest: 1-1.5 mg/kg IVP/IO. Repeat doses at 5 minutes are half the initial (0.5-0.75 mg/kg), Maximum
3 mg total
RSI: TBD
Pediatric Dose
Cardiac Arrest: 1-1.5 mg/kg IVP/IO. Repeat doses at 5 minutes are half the initial (0.5-0.75 mg/kg), Maximum
3 mg/kg total
RSI: TBD
Contraindications
Known hypersensitivity, Stokes-Adams Syndrome, Wolff-Parkinson-White Syndrome, or severe degrees of
sinoatrial, atrioventricular, or intraventricular block in the absence of an artificial pacemaker
Adverse Reactions
Cardiovascular: Bradycardia, hypotension, cardiovascular collapse which may lead to arrest
CNS: Lightheadedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred
or double vision, vomiting, sensations of heat, cold, or numbness, twitching, tremors, convulsions,
unconsciousness, respiratory depression, and arrest
Other: allergic reactions as a result of sensitivity to lidocaine are extremely rare. There have been cases of
permanent injury to extraocular muscles requiring surgical repair
Precautions
Use caution in patients with severe liver or kidney disease because accumulation of the drug or metabolites may
occur. Use caution in patients with hypovolemia, severe CHF, shock, and all forms of heart block. Elimination
of ventricular ectopic beats without prior acceleration in heart rate may promote more frequent ventricular
arrhythmias or complete heart block. Dosage for pediatric and debilitated and/or elderly patients should be
reduced.
Considerations
Observe closely for drug toxicity: dizziness, confusion, delirium, seizures.
Treatment for toxicity is management of symptoms until the drug is removed from the body.
Lidocaine