SODIUM BICARBONATE

Question 1

CLASS

Answer 1

ALKALINIZING AGENT

Question 2

ACTION (2)

Answer 2

BINDS WITH H+ IONS TO FORM WATER AND CARBON DIOXIDE & WITH CO2 EXCRETED BY THE LUNGS DECREASES THE ACIDITY OF THE BLOOD

CAUSE POTASSIUM TO SHIFT INTO CELLS

Question 3

INDICATIONS (6)

Answer 3

PATIENTS WITH KNOWN PERSISTING METABOLIC ACIDOSIS (DKA) IIa

HYPERKALEMIA I

TRICYCLIC ANTIDEPRESSANT OVERDOSE IIa

PHENOBARBITAL OVERDOSE

ALKALINIZE THE URINE IN DRUG OVERDOSES

AFTER PROTRACTED ARRESTS/LONG RESUSCITATION

Question 4

DOSAGE/ ROUTE

Answer 4

SEE HAWAII SO AND FOLLOW ACLS ALGORITHM (tca overdose)

Question 5

STANDARD PREP

Answer 5

50 mEq / 50 cc preloaded syringe

Question 6

PEDS DOSE

Answer 6

SEE HAWAII SO AND FOLLOW PALS ALGORITHM

Question 7

CONTRAINDICATION (2)

Answer 7

METABOLIC ALKALOSIS

RESPIRATORY ALKALOSIS

Question 8

SIDE EFFECTS (5)

Answer 8

PARADOXICAL INTRACELLULAR / TISSUE ACIDOSIS DUE TO CO2 GENERATION AND INADEQUATE VENTILATIONS TO RID CO2 WHICH READILY DIFFUSES ACROSS CELL MEMBRANES

HYPERNATREMIA FROM LARGE SODIUM LOAD

HYPEROSMOLARITY FROM LARGE SODIUM LOAD

MAY SHIFT OXYHEMOGLOBIN DISSOCIATION CURVE TO THE LEFT WHICH CAUSES A DECREASE IN THE RELEASE OF 02 BY HGB TO THE TISSUES

METABOLIC ALKALOSIS

Question 9

PRECAUTIONS

Answer 9

DOSING SHOULD IDEALLY BE GOVERNED BY ABG VALUES

BICARBONATE THERAPY SHOULD BE CONSIDERED ONLY AFTER DEFIB., CPR, ETT, VENTILATION AND TRIAL OF EPINEPHRINE

OVERLY AGGRESSIVE FIELD USE MAY RESULT IN METABOLIC ALKALOSIS

DO NOT MIX WITH CALCIUM CHLORIDE! PRECIPITATES IN LINE IF NOT FLUSHED WELL.