UNCONTROLLED WHEN PRINTED
Introduction
- 150mg in a 3ml ampoule
- Amiodarone has effects within the first four classes of the Vaughan-Williams classification. However it is primarily classified as a Class III antidysrhythmic agent that prolongs the action potential duration and hence the refractory period of atrial, nodal and ventricular tissue. It has characteristics of all Vaughan-Williams classes of antidysrhythmics
- Immediate onset, peak <10min, duration 30-60mins
Indications
- Cardiac Arrest with persistent/shock resistant Ventricular Fibrillation/pulseless Ventricular Tachycardia, post 3rd shock
(ANZCOR 2016).
Critical Care Paramedic only
- Tachydysrhythmias including:
- SVT
- Nodal and Ventricular tachycardia
- Atrial flutter and fibrillation
- WPW syndrome
Contraindications
- No contraindications in cardiac arrest
- Not compatible with Saline (if infusion dose is advocated by a specifically authorised person)
Critical Care Paramedic only
- Hypersensitivity to Amiodarone or iodine
- Bradycardia or AV block
- Sick sinus syndrome
- Severe conduction disorders
- Hypotension
- Severe respiratory failure
- Circulatory collapse
Precautions / Notes
- Heart failure
- Thyroid dysfunction
- Amiodarone is only indicated for shock resistant or recurrent VF / pulseless VT
MUST NOT be diluted into NaCl (e.g. if infusion doses are advised via ASMA / CSP)
Management
Cardiac Arrest
Adult:
- 300mg in 6ml IV/IO as soon as practicable after 3rd shock
- Repeat dose of 150mg in 3ml may be administered after 5th shock
Paediatric / Infant:
- 5mg/kg IV/IO (to maximum 300mg) as soon as practicable after 3rd shock
- Repeat 5mg/kg IV/IO (to maximum 150mg) after 5th shock
Critical Care Paramedic only
Tachydysrhythmias
- 300mg infusion over 20 minutes using Dextrose 5% as a diluent
Special Considerations
- Bradycardia
- Hypotension
- Polymorphic tachycardias
- Nausea
- Tremor
- Dizziness
- Paraesthesia
- Headaches
References
References
Presentation
150mg in 3mL vial
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