Sodium Bicarbonate

Question 1

Class / Action

Answer 1

Class IIb Alkalizing Agent

1. Alkalizing agent binds up hydrogen ions
2. Increases potassium influx into cells
3. Increases pH of urine

Question 2

Onset / Duration of Action

Answer 2

Immediate Onset / Unknown Duration of Action

Question 3

Indications

Answer 3

1. Correct known Hyperkalemia
2. Correct known bicarbonate responsive acidosis; (i.e. DKA or OD of TCAs, ASA, Cocaine, or Diphenhydramine)
3. Prolonged resuscitation with effective ventilation; on return of spontaneous circulation after long arrest interval
4. Crush Injury Syndrome (CIS)

Question 4

Contraindications

Answer 4

Metabolic Alkalosis

Question 5

Precautions

Answer 5

Do Not Mix with Atropine, Calcium Chloride, Epinephrine, Dopamine Isoproterenol, or Vecuronium

Question 6

Dosages / Administration

Answer 6

1. ADULT: 1mEq/kg of 8.4% solution IV/IO
2. For CIS: 100mEq/1000mL NS mixed in (LABLE BAG). Volume replacement and pre-alkalization should take place immediately after CIS identified. Set drip rate to infuse at 1500mL/hour
3. PEDS: NEONATES or CHILDREN <4kg: give 1mEq/kg of 4.2% solution. CHILD >5kg: give 1mEq/kg of 8.4% solution up to 50mEq

Question 7

Adverse Reactions

Answer 7

CHF with SOB and/or Rales