If the arrest rhythm persists after the initial amiodarone dose, what is the recommended second dose and timing?

• A. 150 mg IV/IO bolus 3-5 minutes later
• B. 150 mg IV/IO bolus immediately
• C. 300 mg IV/IO bolus 5 minutes later
• D. No second dose

Answer: (A)

In this scenario the main idea is how amiodarone is dosed when a shockable arrest rhythm continues after the first dose. The initial bolus is 300 mg IV/IO. If the rhythm persists, the recommended next step is to give a second 150 mg IV/IO bolus, about 3 to 5 minutes after the first dose, while continuing CPR and defibrillation attempts. This timing lets the first dose take effect and provides ongoing antiarrhythmic support during the ongoing arrest. The total dose in one arrest should not exceed 450 mg, so a second dose of 150 mg is the intended follow-up rather than another large bolus or no dose.