Premedication for control of ICP (CVA and head trauma) and RAD-induced laryngospasm in patients receiving Rapid Sequence Induction (RSI).
(ACLS/PALS): Ventricular Fibrillation/ Ventricular Tachycardia. Infusion follows bolus and the return to organized non-ventricular rhythm.
Headache, dizziness, hypotension, bradycardia
Potentially Lethal Side Effects:
Convulsions, complete AV block, cardiovascular collapse, respiratory depression.
(ACLS): Coadministration of other anitdysrhythmic, dysrhythmia originating above the ventricles. None in arrest settings. WPW, Adams Stokes and severe block are relative in the emergent setting..
VF/Pulseless VT (ACLS):
IV/ETT Bolus: 1-1.5mg/kg
IV Infusion: 1-4mg/min (Max 3mg/kg)
V-Tach/Wide Complex Tachycardia (with pulse):
IV/ETT Bolus:
Dose 1: 1-1.5mg/kg over 2 minutes**
Dose 2: p 10 minutes from dose 1, 0.5-0.75mg/kg
IV Infusion: 1-4mg/min
Control of ICP prior to Induction*:
IV bolus 1-1.5mg/kg max 3mg/kg
VF/Pulseless VT (PALS):
IV/IO/ETT Bolus: 1mg/kg max 3mg/kg
V-Tach/Wide Complex Tachycardia (PALS):
IV/ETT Bolus: 1mg/kg
IV infusion: 20-50mcg/kg/min
Control of ICP prior to Induction*:
IV bolus 1-1.5mg/kg max 3mg/kg
Mixing: Add 1g Lidocaine to 250cc NaCl.
Using 60gtt/ml set, 15gtt/min=1mg/min; 30gtt/min=2mg/min; 45gtt/min=3mg/min; 60gtt/min=4mg/min
* Local protocols dictate and may vary. Check local protocols.
** Slow administration in a setting with pulses will reduce risks of rapidly lowering BP.
-- Therapeutic range for Lidocaine is 2-6 mcg/ml (U of MN, College of Pharmacy)