Lidocaine HCL

Question 1

What are the indications for use of lidocaine HCL?

Answer 1

• Amiodarone alternative in cardiac arrest from VF/pVT
• Stable monomorphic VT with preserved ventricular function
• Stable polymorphic VT with normal baseline QT interval and preserved LV function when ischemia is treated and electrolyte balance is corrected
• Can be used for stable polymorphic VT with baseline QT-interval prolongation if torsade is suspected
• Procedural anesthetic
• IO infusion pain

Question 2

What is the dosing for lidocaine when used in cardiac arrest from VF / pVT?

Answer 2

Initial dose: 1 - 1.5 mg/kg IVP

If refractory VF may give additional 0.5 to 0.75 mg/kg IVP, repeat in 5 to 10 minutes; maximum 3 doses or total of 3 mg/kg

Pediatric- 1mg/kg IV/IO, q 5 minutes

Question 3

What is the dosing of lidocaine when treating a perfusing arrhythmia (VT/Torsades)?

Answer 3

Adult - 0.5 to 1 mg/kg SIVP, repeat in 5 to 10 minutes; maximum total of 3 mg/kg

Pediatric - 1mg/kg IV/IO, q 5 minutes

Question 4

What is the dose for lidocaine when used for local anesthesia (tetracaine)?

Answer 4

Adult/Pediatric - 1 to 2 drops of 0.5% solution (single dose); apply to affected areas as needed, local anesthetic dosage varies with procedure, degree of anesthesia, vascularity and duration

Question 5

What is the dosage of lidocaine for IO infusion pain?

Answer 5

20 - 40mg slow push (in 0.2mL increments) of preservative-free lidocaine 2%. Toxic dose is 3mg/kg.

Pediatric - 0.5mg/kg IO to a total maximum of 40 mg (2ml) delivered over 2 minutes

Question 6

What are the contraindications for lidocaine HCL?

Answer 6

• Hypersensitivity to lidocaine or amide-type local anesthetics
• Do NOT use prophylactically in AMI
• Do NOT use for Idioventricular rhythms