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 This is Pulse and Pressors — Providing a daily education on the marvels of the human body.