Lidocaine

Question 1

Class

Answer 1

Sodium Channel Blocker (Class 1b Antiarrhythmic)

Question 2

Indications

Answer 2

1. Suppression of V-Fib/pulseless V-Tach refractory to defibrillation
2. Suppression of V-Tach refractory to cardioversion
3. Infusions may also e given to prevent recurrence of V-Fib or V-Tach following conversion (though this is no longer standard practice in the pre-hospital setting)
4. Local anesthesia following IO insertion

Question 3

Contraindications

Answer 3

1. Hypersensitivity to local or aimed-type aesthetics
2. Wolf-Parkinson-White (WPW) syndrome
3. Severe SA, AV, or intraventricular heart block (except with a functioning artificial pacemaker)
4. Allergy to corn or corn-related products (when administering premixed injection; may contain corn-derived dextrose)

Question 4

Dosing for V-Fib/pulseless V-Tach (refractory to defibrillation and epinephrine)

Answer 4

1 - 1.5 mg/kg IV/IO bolus; repeat at 0.5 - 0.75 mg/kg bolus every 3 - 5 min (max dose of 3 mg/kg)

Question 5

Dosing for Hemodynamically stable monomorphic V-Tach

Answer 5

Initial: 1