Medication 7-370 - Lidocaine (Xylocaine)

Polk, Hickory, Cedar, & St Clair EMS Protocols

Scope of Practice:

• Registered Nurse
• Paramedic

Route(s):

• ET, IO, IV, Topical

Pharmacodynamics (class and mechanism of action):

• Antiarrhythmic (Blocks sodium channels, increasing recovery period after repolarization. Suppresses automaticity in the His-Purkinje system and depolarization in the ventricles.).

Pharmacokinetics:

• Half-life: 1.5-2 hours.
• Onset time: Immediate.
• Peak action time: Immediate.
• Duration of action: 10-20 minutes.

• Peak	2	4	6	8	10	12	14	16	minutes
  Duration	2	4	6	8	10	12	14	16	minutes

Dosing:

• Refer to specific protocol(s) below for dose(s).

Indications:

• Protocol 2-968 - V-Fib / Pulseless V-Tach.
• Equipment 8-135 - Intraosseus Needle.

Contraindications:

• High degree heart blocks.
• PVCs in conjunction with Bradycardia.
• Bleeding.

Pregnancy Risk Factor:

• Category B
• No risk in other studies: Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women, or animal studies have shown adverse effects, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

Potential Incompatibilities:

• None.

Precautions and Adverse Effects:

• Monitor for CNS toxicity.
• Liver disease or greater than 70yrs old: reduce dosage by 50%.
• Use with caution in Bradycardia, hypovolemia, shock, Adams-Stokes, Wolff-Parkinson-White.
• May cause Anxiety, drowsiness, dizziness, confusion, Nausea, Vomiting, convulsions, widening of QRS, arrhythmias, and/or hypotension.

Antidote:

• None.

Controlled Substance Information:

• Not a scheduled drug
• The DEA and FDA have not identified this drug with a schedule classification.
• DEA number: NA.
• Narcotic: No.
• Street names: NA.

CMH PHS Mission: "Provide safe, exceptional, and compassionate care to our communities with an emphasis on highly trained and empowered staff."

Polk, Hickory, Cedar, & St Clair County EMS Protocols by Theron Becker is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.