Circulation/CardioCPDI am a MedicNice to knowParamedicsummary

Pharmacology – Drugs for Ventricular Arrhythmias – Lidocaine

Added on day of publication – Can it be used? Yes – there is some evidence – e.g. here – supporting its use, and in other countries including America it is one of the ‘first line options’ (Ray and Clemins, 2025). But should it be used in the UK? Here’s what the BNF says:

Intravenous lidocaine hydrochloride can be used for the treatment of ventricular tachycardia in haemodynamically stable patients, and ventricular fibrillation and pulseless ventricular tachycardia in cardiac arrest refractory to defibrillation, however it is no longer the anti-arrhythmic drug of first choice.
https://bnf.nice.org.uk/treatment-summaries/arrhythmias/#:~:text=Intravenous%20lidocaine%20hydrochloride%20can%20be,arrhythmic%20drug%20of%20first%20choice.

Remember, the Resuscitation Council’s 2021 tachycardia algorithm does not mention lidocaine. It’s always worth checking your local and country-specific guidelines before following any treatment algorithm.


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Louise Sopher is a Paramedic, Resuscitation Practitioner, and Resuscitation Council ALS Instructor based in Hertfordshire. She has been a registered Paramedic for over 5 years. She is the founder of Article 999.

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