# Amiodarone

Separate cardiac-arrest dosing from treatment of unstable wide-complex tachycardia with a pulse.

Population: Adult & pediatric guidance. Scope: ALS.
Status: published. Source-linked OCEMS summary.
Summary updated: 2026-09-16.
Source checked: 2026-09-16.
Source version: I-15 revised March 31, 2026; I-20 revised March 26, 2026. Both implemented April 1, 2026. See linked condition-specific sources..
Canonical page: https://www.ocmedic.com/guides/amiodarone/
Official source: [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf)

Independent OC Medic summary. Does not replace the complete policy, current system notices, or clinical judgment.

## Check before giving

- A pulse changes the administration sequence and rate.
- Slow administration in patients with a pulse is important: SO-C-040 warns about profound hypotension.

## Source documents

- [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf#page=1)
- [I-20 — Pediatric Medication Volume Dose by Weight](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-20%20Peds%20Drug%20Guide%2004-2026.pdf)
- [SO-C-010 — Cardiopulmonary Arrest - Adult / Adolescent Non-Traumatic](https://www.ochealthinfo.com/sites/hca/files/2021-06/SO-C-10%20Cardopulmonary%20Arrest%20-%20AdultAdolescent%20Non-Traumatic%20%2810-1-2021%29%20-%20Revised.pdf)
- [SO-C-040 — Wide QRS Complex Tachycardia with a Pulse - Adult/Adolescent](https://www.ochealthinfo.com/sites/healthcare/files/2025-10/SO-C-40%20VT%20with%20Pulse%20%2810-2025%29.pdf)
- [SO-P-040 — Cardiopulmonary Arrest - Pediatric](https://www.ochealthinfo.com/sites/healthcare/files/2025-11/SO-P-40%20Cardiac%20Arrest%2011-25.pdf)

## Use in OCEMS

- An antiarrhythmic option in the OCEMS VF/pulseless-VT sequence and the unstable wide-complex tachycardia pathway.
- Stable adult wide-complex tachycardia is generally monitored and transported under SO-C-040 without cardioversion or antiarrhythmic treatment.

## Adult / adolescent

| Indication / route | Dose & limits |
| --- | --- |
| VF / pulseless VT | 300 mg IV/IO; may repeat 150 mg once after 3 minutes in the resuscitation sequence. |
| Unstable wide-complex tachycardia with a pulse | 150 mg slow IV/IO after unsuccessful initial cardioversion. Follow SO-C-040 for repeat cardioversion and the second 150 mg dose. |

## Pediatric

- SO-P-040: for persistent VF/pulseless VT, 5 mg/kg IV/IO; it permits repeat 5 mg/kg doses at 5 and 10 minutes and lists a maximum dose of 450 mg. Follow the full arrest sequence and obtain base contact.
- I-20 marks VT with a pulse as a base-order indication and lists infusion over 10 minutes. Use the ordered dose and the correct weight-band entry; do not substitute the arrest administration method.

## Pediatric weight table — Persistent VF / pulseless VT

- Source: SO-P-040. Dose rule: 5 mg/kg; route: IV/IO.
- Initial arrest dose: 5 mg/kg IV/IO. The source permits repeat doses at 5 and 10 minutes and states a maximum of 450 mg; account for medication already given before any repeat.
- Base contact is required. This table is for pulseless arrest, not VT with a pulse. The base-ordered perfusing-VT regimen is a separate slow infusion.
- Calculated examples for the exact weights shown, using the named standing-order/procedure formula. Do not round the patient’s weight to the nearest row. For another weight, calculate from the stated formula and apply the limits. These are not the rounded I-20 weight-band volumes.
- Volumes are mathematical examples rounded to at most three decimal places. Verify the vial concentration, dose, and measurable syringe volume before administration; follow agency preparation/rounding practice.
| Exact weight | Dose — IV/IO | Volume at 50 mg/mL |
| --- | --- | --- |
| 3 kg | 15 mg | 0.3 mL |
| 4 kg | 20 mg | 0.4 mL |
| 5 kg | 25 mg | 0.5 mL |
| 6 kg | 30 mg | 0.6 mL |
| 8 kg | 40 mg | 0.8 mL |
| 10 kg | 50 mg | 1 mL |
| 12 kg | 60 mg | 1.2 mL |
| 15 kg | 75 mg | 1.5 mL |
| 20 kg | 100 mg | 2 mL |
| 25 kg | 125 mg | 2.5 mL |
| 30 kg | 150 mg | 3 mL |
| 35 kg | 175 mg | 3.5 mL |
| 40 kg | 200 mg | 4 mL |
| 45 kg | 225 mg | 4.5 mL |
| 50 kg | 250 mg | 5 mL |
| 60 kg | 300 mg | 6 mL |

## Pediatric weight bands — VT with a pulse

- I-20 pages 1–10: base hospital order required; infuse over 10 minutes using the ordered route. This is not the pulseless-arrest bolus.
- Values below are the published I-20 band doses. Confirm the base order and chart; do not extrapolate beyond these bands.
| I-20 weight band | Base-ordered dose over 10 minutes | Volume at 50 mg/mL |
| --- | --- | --- |
| 3–5 kg | 20 mg | 0.4 mL |
| 6–7 kg | 30 mg | 0.6 mL |
| 8–9 kg | 40 mg | 0.8 mL |
| 10–11 kg | 50 mg | 1 mL |
| 12–14 kg | 70 mg | 1.4 mL |
| 15–18 kg | 75 mg | 1.5 mL |
| 19–23 kg | 100 mg | 2 mL |
| 24–29 kg | 125 mg | 2.5 mL |
| 30–36 kg | 150 mg | 3 mL |
| 37–49 kg | 150 mg | 3 mL |

## Preparation & reassessment

- The listed preparation is 50 mg/mL. Confirm ordered milligrams and the matching volume.
- Maintain rhythm and perfusion monitoring. Medication is one part of the electrical-treatment/resuscitation pathway.