Amiodarone help!

why was the pt unresposive w/ a SBP 180?

300 amio IVP is usually given w/ VF/unstable VT. This sounds like hemodynamically stable VT if I'm reading you right.

I'm pretty sure amio can be given in any case of vtach pulseless or not. Its an antiarrhythmic agent and per acls the dose is 300mg iv push for the first dose and 150 after.

New nurse here looking for help. Has anyone pushed amiodarone 300mg for a patient in VTACH with a pulse. Pt was unresponsive and post cardiopulmonary arrest. HR was over 130 and BP was 180's/90's (i know hypotension is an issue) No medications administered prior to this order. Only a shock at 200j per EMS prior to arrival. I have given amiodarone bolus of 150mg over 10 minutes then 1mg/min after that. I have pushed amiodarone 300mg for a pulseless patient. I work in a small hospital with no interventional cardiology services. Just wondering if its a standard I'm missing. If so, can someone recommend a resource or reference?

I'd be more concerned about the fact that the patient's pulse pressure is wide. He may be having some neurologic events, although it usually is accompanied by bradycardia, not tachy. But VTach at 130 with a pulse? I don't think 300mg is the appropriate dose. Maybe more appropriate to give 150 slowly and start the gtt.

Was this ordered by the Physician?

As I remember per ACLS guidelines you give 300mg if the pt has NO pulse. If the pt HAS a pulse then you give 150mg, followed by a drip of 1mg per hour for so many hours (can't remember exactly how many), then 0.5mg/hr and then off. I think total the drip runs for 16 hours.

I took it as the pt had a cardiac arrest was the subsequently non responsive, and had an episode of V-tach.

Doctors are not always ACLS certified. Which means that they may not be up to date on the latest guidelines. Per the latest ACLS guidelines 300mg IVP is for dead people only - No Pulse. I find that as a member of the code team sharing this information with the provider can be a good clue to prevent wrong dosages. You could have stated it: "I thought that the correct dosage for a stable pt was 150mg IVPB over 10 min?". You're never wrong to ask or clarify.

Be empowered and share your knowledge.

Are you really stable if you are unresponsive? Bp or not, the patient is post code. Doesn't sound stable to me.

This patient may be unconscious post resuscitation and this may be hours post code......if there is a good B/P of 180 systolic I would not call that unstable VT IMHO

not an opinion. a fact.

I'm an ACLS instructor and per guidelines the correct dose should be 150mg. One exception that is mentioned in the manual is to consult expert consultation. Expert consultation can override the standard ACLS procedure.