View source for Premature Ventricular Contractions (PVC)

==Section 4 - CARDIAC== 
===4.05 PREMATURE VENTRICULAR CONTRACTIONS (PVC)===

'''''CONSIDER MEDICAL ETIOLOGY OF PVC’s AND REFER TO APPROPRIATE PRACTICE PARAMETER:'''''


* Hypoxia, [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01).
* Side-effects of other drugs, etc.
* [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01). - [[Medical Gases|OXYGEN]] @ 100% via NRB mask or assist with BVM.
* Treat if PVCs are consistent in patients with signs and symptoms which suggest '''angina / myocardial infarction''': 
** 6 per minute 
** Multifocal 
** R on T phenomena 
**Runs of V-Tach / Couplets

* Administer LIDOCAINE 1 to 1.5 mg/kg IVP, IO 
**Patients receiving LIDOCAINE need to receive a full loading dose titrated to suppress the PVC’s. 
*** In patients over age 70 or in those with known hepatic disease, administer LIDOCAINE gradually up to a full initial loading dose or until a maximum of 1.5 mg/kg administered. 
**If recurrent or refractory and patient is symptomatic, administer bolus of LIDOCAINE 0.5 mg/kg IVP, IO and repeat as necessary up to a total administration of 3 mg/kg. 
*** In patients over age 70 or in those with known hepatic disease, repeat doses need to be carefully titrated to suppress PVC’s given over a long period of time. These patients may have reduced lidocaine clearance therefore can reach toxic levels or develop seizures with doses lower than 3 mg/kg.

[[Category:Cardiac|0405]]