Lidocaine is one of several ACLS drugs used to treat cardiac arrest from ventricular tachycardia (VT) and ventricular fibrillation (VF). Lidocaine is considered a second-line antiarrhythmic drug and should be administered in VF/VT cases where amiodarone is either unavailable or ineffective. Lidocaine comes in different strengths and concentrations, such as gel, spray, cream, lotion, ointment, liquid solution for injection, skin patch, and others.
Lidocaine is also used as a local anesthetic agent. QUAD A facilities that are required to have Lidocaine at their facility as a required ACLS medication and use Lidocaine as a local anesthetic agent must ensure that the correct concentration of Lidocaine is present as an ACLS medication in the event of a patient cardiac emergency. The correct Lidocaine is Lidocaine HCL 2% Inj. 100 mg/5 ml. The box also indicates “I.V. for Cardiac Arrhythmias” and generally comes in a red box.
Plain Lidocaine 1% or 2% for injection is used as a local anesthetic. Plain Lidocaine for injection is NOT a substitute for Lidocaine HCl 2% as a required ACLS medication. Bupivacaine is also NOT a substitute for Lidocaine HCL 2% used in ACLS. If used during a patient's cardiac emergency, plain Lidocaine or Bupivacaine can cause SIGNIFICANT patient harm. We have recently seen incorrect Lidocaine in the emergency cart in several facilities. These findings have resulted in cited deficiencies that demonstrate egregious non-compliance, placing patients at significant risk for immediate harm, resulting in an immediate jeopardy situation.
With QUAD A accreditation, patient safety is first. Please review the lidocaine present in your facility, required by the ACLS algorithm, to ensure that it is Lidocaine HCl 2% I.V. for Cardiac Arrhythmias. As another reminder, please keep in mind that multi-dose vials that have entered the immediate patient care area are considered single-dose vials and must not be used for other patients.
Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.
