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Lidocaine: Emergency Medications

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Lidocaine: Emergency Medications was discovered in 1946 and went on sale in 1948.

Hi there marius here with the resuscitation coach on this channel we do all things resuscitation so please consider subscribing in today’s video we’ll continue with our emergency medication series we’ll be reviewing lidocaine so let’s jump straight in here we go lidocaine is also known as lignocaine in this session we’ll be reviewing the mechanism of action of

Lidocaine the indications the dosages for both adult and pediatric resuscitation and some of the precautions and side effects lidocaine depresses the automaticity of the pukenji fibers raising the stimulation threshold in the ventricular muscle fibers which makes the ventricle less likely to fibulate the indications for lignocaine includes lignocaine can be used

As an alternative to a mutaron in cardiac arrest from vf or pulseless ventricular tachycardia can also be used for stable monomorphic ventricular tachycardia with preserved ventricular function stable polymorphic ventricular tachycardia with normal baseline qt interval and preserved lv function when ischemia is treated and electrolyte balance is corrected can

Also be used for stable polymorphic vt with baseline acute interval prolongation if torsades is suspected in cardiac arrest from vf or pulseless ventricular tachycardia the initial dose is 1 to 1.5 milligrams per kilogram iv or io for refractory vf we may give an additional 0.5 to 0.75 milligrams per kilogram iv push and repeat it in 5 to 10 minutes maximum dose

Is three milligrams per kilogram the pattern followed by clinicians in vf or pulses ventricular tachycardia arrest is usually high quality cpr defibrillate once defibrillate for a second time give epinephrine defibrillate for the third time give lidocaine defibrillate for a fourth give happy determinate for a fifth give lidocaine defibrillate for the sixth give

Epinephrine i always remember that after the equal number of shocks shock two four six the patient for instance will receive an ep and after uneven number of shots shock 3 and 5 the patient will receive lidocaine all assuming that the rhythm did not change from vf or pulseless ventricular tachycardia to something else in between if this pattern is followed your

Patient will receive one dose of epinephrine every four minutes and one dose of lidocaine every four minutes usual dose interval for both medications are every 3 to 5 minutes as per the american heart association guidelines it should be noted that lidocaine doses could be replaced with a murderone as an alternative we have discussed a mutant in a previous video

In the emergency medication series cd card above for stable vt y complex tachycardia of an uncertain type or with significant ectopic doses ranging from 0.5 to 0.75 milligrams per kilogram and up to 1 to 1.5 milligrams per kilogram may be used repeat 0.5 to 0.75 milligrams per kilogram every 5 to 10 minutes maximum total dose is 3 milligrams per kilogram

For the maintenance infusion your dose is 1 to 4 milligrams per minute which is 30 to 50 mics per kg per minute the pulse dosage for lidocaine for refractory ventricular fibrillation or pulseless ventricular tachycardia is one milligrams per kilogram iv or io your et dosage is two to three milligrams per kilogram the maintenance infusion is 20 to 50 mics per

Kilogram per minute we need to repeat the bolus dose if the infusion was initiated more than 15 minutes after the initial bolus therapy for rapid sequence intubation you could also give one to two milligrams per kilogram iv or i o the pattern followed for pediatric cardiac arrest with vf or passes ventricular tachycardia is the same as for the acls so your

Equal number of shocks will be followed by epinephrine and your uneven number of shocks shock 3 and shock 5 will be followed by lidocaine as long as the rhythm did not change from vf or pulses vt to another rhythm lidocaine is country indicated for prophylactic use in ami patients in the presence of impaired liver function reduce the maintenance dose and not

The loading dose discontinue the infusion immediately if signs of toxicity develop also caution in patients with renal insufficiency some of the side effects of lidocaine can include muscle twitching slurred speech hearing loss altered level of consciousness and seizures if you benefited from this video kindly like subscribe and smash that notification bell

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Transcribed from video
Lidocaine: Emergency Medications By The Resuscitation Coach