INDICATIONS

• Ventricular fibrillation / ventricular tachycardia
• Wide-QRS tachycardia
• Adjunct to intubation (may decrease ICP, which may increase secondary to intubation)

PRECAUTIONS & CONTRAINDICATIONS

• May cause cardiovascular depression when given in higher doses
• CNS toxicity (i.e. seizures)
• Reduced dose in severe heart failure, renal or hepatic failure
• Contraindicated in patients with wide-QRS escape rhythms

DOSAGE & ADMINISTRATION

IV/IO:

• Loading: 1.0 mg/kg
• Maintenance: 20–50 mcg/kg/hour (may repeat bolus 15 minutes after initial bolus)
• May be given via ET (not recommended in the 2025 Guidelines)
• For intubation: 1.0–2.0 mg/kg bolus