Sodium Bicarb

Question 1

Sodium Bicarb - class (1)

Answer 1

• alkalinizing agent

Question 2

Sodium Bicarb - Action (2)

Answer 2

• binds w/ Hydrogen ions to form H2O and CO2 with CO2 excreted by lungs, decreasing the acidity of blood- cause potassium (k) to shift into cells

Question 3

Sodium Bicarb - Indications (6)

Answer 3

AM PHAT- pt’s with known pre-existing metabolic acidosis (DKA)- Hyper K- TCA OD- Phenobarbitol use- alkalinize urine in drug OD- prolonged CPA

Question 4

Sodium Bicarb - contraindications (1)

Answer 4

• Metabolic/Respiratory Alkalosis

Question 5

Sodium Bicarb - Side Effects (5)

Answer 5

• paradoxical intracellular/tissue acidosis due to Co2 generation & inadequate ventilation to rid CO2 which readily diffuses across cell membranes- hypernatremia from large sodium load- hyperosmolarity from large sodium load- may shift O2 curve to left which causes a decrease in release of O2 by hgb to tissues- metabolic alkalosis

Question 6

Sodium Bicarb - Precautions (4)

Answer 6

• give based on ABG values- bicarb therapy should be considered only after defib, CPR, ETT/vent, trial of epinephrine- overly aggressive field use may result in metabolic alkalosis- do not mix with CaCh precipates in line