ACLS and Lidocaine | ACLS-Algorithms.com

Comments

  1. saira says

    can lidocaine be used for hemodynamically stable non-sustained VT in the setting of normal electrolytes, left ventricular function and decompenseated liver disease?

    • Jeff with admin. says

      I do not know why you would want to use lidocaine if the patient is hemodynamically stable and the VT is non-sustained. AHA ACLS protocol would call for expert consultation at this point. Lidocaine is not listed as a treatment of choice for stable non-sustained VT with a pulse. Amiodarone is. I personally would get the expert advice of a cardiologist especially since the patient is stable.

      Kind regards,
      Jeff

  2. Gayl says

    Can Amiodarone be pushed IVP, without being diluted in D5W, for a patient in V Tach with a pulse. Had a doctor yelling at us to do this, but I reminded him that Amiodarone for perfusing V Tach (stable) needed to be dripped over 10 minutes.

    • Jeff with admin. says

      Amiodarone can be pushed. It is better to dilute the amiodarone in 10 to 20 ml of D5W, but it can be given undiluted.
      In the case of stable VT, it is appropriate to infuse the amiodarone over 10 minutes. Rapid IV push of amiodarone should be reserved for unstable VT, pulseless VT and VF.

      Kind regards,
      Jeff

  3. Lisa says

    So amiodarone with D5W…Nor Epi as well right?? Others with NS
    All ACLS drugs can be pushed as fast as you can during a code..however please tell me more on the drips..trying to make it simple
    If I were to start a drip of amiodarone…in the ER what to should I know…also Lidocaine and Epi
    Also what about filters

    • Jeff with admin. says

      Norepinephrine is usually diluted with D5W. Other fluids are diluted with NS. All ACLS drugs during a code are pushed as fast as possible and followed with 20ml of NS. Drips in the post arrest phase are hung just as any other drips are. Amiodarone does need a filter. None of the others do.
      All drips should be titrated up or down for affect.

      Kind regards,
      Jeff

  4. Emily says

    I know we use Lidocaine as a laryngojet to help with coughing against ett. Does putting lidocaine down the ETT help also with ectopy or other ventricular arrythmias, kind of like how we can put epi down the ett for administration? We were having a conversatoin about this at work tonight and I was just wondering 🙂

    • Jeff with admin. says

      Lidocaine can be administered via endotracheal tube, dilute dose in 5–10 mL of 0.9% sodium chloride or sterile water or flush with a minimum of 5 mL of 0.9% sodium chloride followed by manual ventilations .

      Kind regards,
      Jeff

    • Jeff with admin. says

      Lidocaine can be diluted with NS also.
      About the only listed in the ACLS core medications that cannot be diluted with NS is amiodarone.
      Dilute an amiodarone infusion with D5W.

      Kind regards,
      Jeff

      h NS also.
      About the only listed in the ACLS core medications that cannot be diluted with NS is amiodarone.
      Dilute an amiodarone infusion with D5W.

      Kind regards,
      Jeff

    • Jeff with admin. says

      Refractory VF is ventricular fibrillation that will not respond to standard treatments for VF. To put it another way, it is VF that won’t go away when shocked or treated with medications.
      Kind regards,
      Jeff

    • Jeff with admin. says

      Epinephrine is the only catecholamine used in the AHA pulseless arrest algorithm so I suppose that you could say it stands alone.

      Vasopressin, Amiodarone, and Lidocaine which are also mentioned in the guidelines for the pulseless arrest algorithm are not catecholamines.

      Dopamine and Norepineprine which are catecholamines that are used in the post arrest phase of ACLS protocol.

      Kind regards,
      Jeff

  5. Matthew says

    Hey, just wanted to know when they brought Amiodarone on-board in the ACLS algorithms? Just a year would suffice.

    Thanks

  6. Shirna says

    What are the drugs used for the ETT route other than narcan, vasopressin, and epinephrine per your information?
    I learned L-A-N-E (lidocaine, atropine, narcan, and epinephrine).

      • Louise says

        I am confused. LEAN was the last acronym I was taught for ETT drugs. Lidocaine, epi, atropine, narcan. Is NAVEL still appropriate and useful?

        Thank you for your site, it is being a great help.

      • Jeff with admin. says

        Either on will work, but you need to had a V to the LEAN. Vasopressin can be given by ET tube as well. NAVEL uses all of the letters with a word that is easy to remember.
        Kind regards,
        Jeff

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