Figure 2-30. R-on-T phenomenon ending in ventricular fibrillation.
Treatment. Administer lidocaine.
(a) Administer lidocaine if any or all of the following are present:
1 Frequent PVCs (more than 6 per minute).
2 Premature ventricular contractions frequently coupled.
3 Multifocal PVCs (Premature ventricular contractions which are
different shapes and sizes).
4 Bursts of two or more PVCs in succession.
(b) Give this dosage:
1 Initially, give 1.0 mg per kilogram of weight of lidocaine IV bolus.
2 Additionally, 0.5 mg/kg IV boluses can be given every 2 to 10
minutes, if necessary to a total of 3 mg/kg intravenously.
If transport time is excessive, consider continuous infusion at 1 to 4
(d) If PVCs occur and the casualty is also experiencing bradycardia,
treat the bradycardia first.