How is the first dose of Amiodarone delivered in shockable rhythms?

The correct approach for delivering the first dose of Amiodarone in the setting of shockable rhythms, such as ventricular fibrillation or pulseless ventricular tachycardia, is to administer it intravenously. The standard initial dose is 300 mg, typically given as a bolus in 20 ml of a compatible diluent. This rapid intravenous delivery ensures that the medication reaches the bloodstream quickly, which is essential during a cardiac emergency when immediate action is necessary to restore a normal heartbeat.

Delivery routes like intramuscular, oral, or subcutaneous would not provide the same rapid effect needed during resuscitation efforts. Intramuscular injections can have variable absorption rates that are unsuitable in emergencies, while oral administration would be too slow and ineffective given the urgency of treating life-threatening arrhythmias. Subcutaneous routes are also impractical for urgent medication delivery in these scenarios. Thus, intravenous administration is the correct and most effective method for delivering Amiodarone in this context.