Sodium Bicarbonate

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Classification:  

  Alkalinizing agent, Antidote

Action:       

Binds with hydrogen atoms to form carbonic acid.

Neutralizes excess buildup of acids

Assists in restoring normal pH

Indications:             

 Prolonged cardiopulmonary arrest with suspected:

Hyperkalemia (renal patients)

      Tricyclic antidepressant overdose

Crush Syndrome with suspected

hyperkalemia

Contraindications: 

None in emergency setting

Adverse Effects:  

Respiratory

pulmonary edema

Neurological

headache

confusion

seizures

tetany

Metabolic

alkalosis

hypokalemia

hypocalcemia

tissue acidosis

Administration:

Cardiac arrest   

        1mEq/kg - IV/IO.  May repeat 0.5 mEq/kg in 10-15 minutes.

Crush syndrome

          1mEq /kg added to first 1000ml NS.

Pediatrics:   

Cardiac           1mEq/kg slow IV/IO at 10ml/minute.  May repeat 0.5mEq/kg every 10-15 minutes.

Crush syndrome       Same as adult

Onset:       

Duration:               

Onset:                         Immediate

Duration:                   1-2 hours

Precautions:           

May cause tissue necrosis (verify IV patency)

Flush line prior to administration:

            -Percipitates with Calcium Chloride

            -Inactivates catecholimines