Lidocaine for V-Fib and V-Tach: An Emergency Medication Explained

Timestamp Topic Title
[00:00] Introduction: Lidocaine as a Class IB Anti-Arrhythmic
[00:27] Mechanism of Action: Blocks Voltage-Gated Sodium Channels in Inactive State (Targets Ischemic Tissue)
[00:58] Pharmacokinetics: Rapid Onset, Short Half-Life, Saturable Hepatic Metabolism (Adjust in HF/Post-Bypass)
[01:25] Hemodynamics: Generally Stable (Safe for Low Myocardial Oxygen Demand)
[01:40] Dosing and Titration (1-1.5 mg/kg bolus, 1-4 mg/min infusion)
[01:54] Toxicity (Neurologic Symptoms, Seizures, Cardiovascular Collapse, Lipid Emulsion Rescue)
[02:40] Indications: Monomorphic VT (Especially Ischemia-Related or Post-Cardiac Surgery)
[03:37] Indications: Ventricular Fibrillation (Adjunct After Defibrillation/Epinephrine)
[04:08] Ineffectiveness Against Supraventricular Tachyarrhythmias (AFib/Flutter/SVT)
[04:47] Contraindications: Idioventricular/Escape Rhythms, Torsades de Pointes
[05:07] Dosing Adjustment Post-Cardiopulmonary Bypass (Reduce Infusion 50%)
[05:25] Absolute Contraindications (Severe AV Block, WPW, Amide Hypersensitivity)
[05:37] Summary Pearls (Selectivity for Ischemic Tissue, Hepatic Metabolism, Toxicity)

Lidocaine is more than just a local anesthetic — in critical care, it’s a life-saving antiarrhythmic and pain management tool. In this quick ICU crash course, we break down how Lidocaine works, when to use it, and how to monitor for toxicity.

You’ll learn:
⚡ The mechanism of action (how it stabilizes cardiac membranes)
❤️ Its role in managing ventricular arrhythmias and post-MI care
💉 Dosing, IV vs. local routes, and lidocaine infusions
🚨 Signs of toxicity — from CNS symptoms to cardiac depression
🧠 Clinical pearls every bedside nurse and provider should know

Whether you’re in the ICU, ED, or OR — this is your quick, clear, no-fluff guide to mastering Lidocaine.

#Lidocaine #ICUPharmacology #CriticalCareNursing #PulseAndPressors #NursingEducation #CardiacArrest #Antiarrhythmic #MedicalEducation#cardiology#cardiothoracicsurgery #cardiothoracic #icu #cvicu

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