Sodium Bicarbonate

Question 1

Sodium Bicarbonate
Type

Answer 1

Alkalinising Solution

Question 2

Sodium Bicarbonate
Action 3

Answer 2

Reverses metabolic acidosis by buffering hydrogen ions

Reduces plasma potassium by altering pH and causing intracellular movements of potassium ions

Alters protein binding of tricyclics by acting on trans-membrane sodium channels

Question 3

Sodium Bicarbonate
Route Onset Peak Duration
IV

Answer 3

Sodium Bicarbonate
Route Onset Peak Duration
IV Immediate N/A N/A

Question 4

Sodium Bicarbonate
Uses 2

Answer 4

C9 - Hyperkalaemia
DT9 - Tricyclic antidepressants
Adverse Effects

Question 5

Sodium Bicarbonate
Adverse Effects 3

Answer 5

Metabolic alkalosis (may cause dysrhythmias)
Heart failure
Hypokalaemia (may cause dysrhythmias)

Question 6

Sodium Bicarbonate
Contraindications

Answer 6

Nil for ASNSW

Question 7

Sodium Bicarbonate
Preparation

Answer 7

8.4% 100mL (1mmol:1mL) bottle

Question 8

Sodium Bicarbonate
Notes

Answer 8

Sodium bicarbonate and calcium gluconate precipitate when mixed together. Flush the line between administration of these medications.

Question 9

Sodium Bicarbonate
Indications for
Hyperkalaemia

Answer 9

Actual or suspected hyperkalaemia with progression of ECG changes (ECG changes include - T waves becoming tall and peaked, P wave disappearing, QRS widening, Presence of a sine wave pattern and Asystole/VT/VF)

Question 10

Sodium Bicarbonate
Indications for
Tricyclic Antidepressant Overdose

Answer 10

Tricyclic overdose with conduction delay (wide QRS complex) presenting with shock, coma or convulsions

Question 11

Sodium Bicarbonate
Dose
All ages all indications

Answer 11

IV
1mmol/kg bolus (Max bolus: 100mmol)
Nil Repeat
Max total 1mmol/kg (up to 100mmol)