What is the recommended dose of amiodarone for the first administration during adult cardiac arrest?

The recommended dose of amiodarone for the first administration during adult cardiac arrest is 300 mg given as a bolus. This dosing is advised in cases of refractory ventricular fibrillation or pulseless ventricular tachycardia. The aim of this higher initial dose is to maximize the chances of restoring a normal rhythm effectively, particularly when standard resuscitation efforts have not resulted in a return of spontaneous circulation.

This 300 mg bolus is critical because it provides a sufficient amount of the drug to initiate its therapeutic effects on the heart's electrical conduction system, thereby attempting to stabilize the rhythm or convert the arrhythmia. Following this initial dose, further doses can be administered if needed, tailored based on the patient's response and subsequent clinical assessment. This dosing strategy is part of advanced cardiac life support protocols designed to improve outcomes in critical cardiac events.