MED-Sodium Bicarbonate

Electrolyte, Alkalinizing Agent

Given IV: Immediately raises blood pH by buffering excess H+ cations. Excess bicarbonate ions are excreted in urine thus making urine less acidic.

• Severe acidosis refractory to hyperventilation
• Tricyclic antidepressant overdose
• Barbituate overdose
• Known hyperkalemia

None in emergency setting

• Not recommended for routine use in cardiac arrest
• Dosage must be specific to prevent metabolic acidosis and is thus weight based

• Severe necrosis if extravasation occurs
• May produce paradoxical acidosis that can depress cerebral and cardiac function
• May cause extracellular alkalosis which may reduce the concetration of ionized calcium, decrease plasma potassium, and induce a left shift of the oxyhemoglobin curve which may inhibit oxygen release to the tissues and induce malignant dysrhythmias

• Will deactivate most catecholamines and vasopressors
• Sodium bicarbonate will form precipitate in conjunction with calcium chloride

• 1 mEq/kg IVP/IO repeat at
• 0.5 mEq/kg q 10 mins prn