Amiodarone-Using It? Any Info?

[G]

Anyone using Amiodarone prehospitally?

For what? what dosing schedule(s)? Following bolus with drip?

Any studies/literature availabe also greatly appreciated

[Our region is considering immediately implementing in ACLS algorithms at least to replace Bretylium since nobody can get any more of it. This is the largest motivator to do it now instead of waiting for next year's roll slow rollout of the new AHA ACLS guidelines. Possibly we may even place it a step ahead of Lido]

G


PS-I'm familiar with the A.R.R.E.S.T. study
& a few others which suggest it works;
Does anyone know the status of the
A.L.I.V.E. study (Lido vs. Amiodarone head
to head study)-Is is completed? published?
------------------
These are my own thoughts/opinions; not necessarily those of my affiliations-YES,I THINK!


[This message has been edited by G (edited December 15, 1999).]

[Firemedic1696]

Loyola University EMS System
(Chicago suburbs)is using Amiodarone in the field. Used in V-fib/V-tach (Pulsless) after D-fib (x3) given with the intial bolus of Epi. 300 mg fast IVP. No drip to follow, just the one bolus. Our protocal is the same otherwise. Can not put down the tube, no peds patients, can be used in trauma, only IVP The only problems with it is that it is senstive to shock which makes storage for prehospital difficult. Secondly, it is packaged in ampules 150 mg per ampule, which means we need two. This has to be done in the first few minutes of an arrest. My understanding is that it will be in the 2000 edition of ACLS, I am not sure where, and this will spur manufactures to create preloads for emergency use. I dont have any outcome information to post, this is a newer protocal, results have not been made public.

[Trauma_Dog]

We have been using Cordarone for the last 2 years and we have seen a very significant increase in the number of ROSC's (return of spontainous circulation).
PROTOCOL
shock x 3
ET and IV
EPI
shock
Corarone 300mg bolus, if converted from Cordarone we mix 150mg in 100ml and infuse over 10 min.

We also use it for ventricular ectopy the same as the post resusitation 150 mg in 100ml and infuse over 10 min.

Please note that our ROSC and CPR saves are different a save has to walk out of the hospital and all others are ROSC's. Sorry I do have any data on the actual saves, however it seems to be on the rise.

Kent Simon Paramedic Incharge
MCHD EMS