Amiodarone in a rush: caution on speed of delivery and new guidance

A boy aged 11 months presented to his local hospital with a short history of being febrile with vomiting. He was found to be shocked with a pulsed broad complex tachycardia of around 240 and increased work of breathing. He was managed as per the APLS (Advanced Paediatric Life Support) protocol and had short-lived terminations after his first two shocks. He was loaded with amiodarone over 5 min prior to his third shock, but promptly arrested with loss of electrical activity requiring 20 min cardiopulmonary resuscitation. This transitioned to a return of broad complex tachycardia with output and a further 20 min of shocks and epinephrine until a narrow complex rhythm was achieved and the paediatric critical care transport service (PCCTS) transferred him out shortly thereafter. This case highlights the risk of bolus or fast administration of amiodarone. The team accurately followed APLS guidance at the time, however this has since been...
Source: Archives of Disease in Childhood - Category: Pediatrics Authors: Tags: PostScript Source Type: research