turbosinaboy

MM, nop. We don't hve procainamide. I have heard it is VERY expensive and really hard to get here. Now the new 2005 AHA & ECC guidelines are out in the wild for everyone. Procainamide is not anymore there. Amiodarone is still before Lidocaine. Until now we have no evidence to support the use of Lidocaine prior to Amiodarone. Basically because we are not making (at my EMS) any important/big data collection (good reason, huh?). But even given the last results, something deeper in me still wonders what will happen when the Amiodarone's patent expires.

Even with the Amiodarone being first place before Lidocaine in ACLS, I have heard that there's not such thing as the better. As said before, it's up to the patient's particular condition, sodium, potassium, and other levels. If you have all the metrics and are in the ER you can make some decisions. It is said that Lidocaine lost first place at the same time it lost the Patent (so it is very cheap) and Amiodarone (not so cheap) took the place. I can only say that I have not any success history with any of them -few time using them, not a lot of lost patients ;-)-, but what have heard is that although there's not a clear difference some people would prefer to use Lidocaine in first place (they use Amiodarone, because of the ACLS), maybe just because they are used to.