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Amiodarone

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

OCEMS source summary · Updated 2026-09-16

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.

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 / routeDose & limits
VF / pulseless VT300 mg IV/IO; may repeat 150 mg once after 3 minutes in the resuscitation sequence.
Unstable wide-complex tachycardia with a pulse150 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 weightDose — IV/IOVolume at 50 mg/mL
3 kg15 mg0.3 mL
4 kg20 mg0.4 mL
5 kg25 mg0.5 mL
6 kg30 mg0.6 mL
8 kg40 mg0.8 mL
10 kg50 mg1 mL
12 kg60 mg1.2 mL
15 kg75 mg1.5 mL
20 kg100 mg2 mL
25 kg125 mg2.5 mL
30 kg150 mg3 mL
35 kg175 mg3.5 mL
40 kg200 mg4 mL
45 kg225 mg4.5 mL
50 kg250 mg5 mL
60 kg300 mg6 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 bandBase-ordered dose over 10 minutesVolume at 50 mg/mL
3–5 kg20 mg0.4 mL
6–7 kg30 mg0.6 mL
8–9 kg40 mg0.8 mL
10–11 kg50 mg1 mL
12–14 kg70 mg1.4 mL
15–18 kg75 mg1.5 mL
19–23 kg100 mg2 mL
24–29 kg125 mg2.5 mL
30–36 kg150 mg3 mL
37–49 kg150 mg3 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.