Sodium bicarbonate

Question 1

Sodium bicarbonate - Type

Answer 1

Hypertonic alkaline solution - 8.4% sodium bicarbonate solution.
Contains 1mmol/ml sodium and 1 mmol/ml bicarbonate

Question 2

Sodium bicarbonate - Presentation

Answer 2

50ml sodium bicarbonate solution

Question 3

Sodium bicarbonate - Actions (2)

Answer 3

1. Neutralises metabolic acidosis as a result of cardiac arrest or poor perfusion
2. Causes movement of K into cells - swaps with H ions
   Onset 30-60 sec

Question 4

Sodium bicarbonate - Uses (4)

Answer 4

1. Cardiac arrest secondary to cardioactive drug overdose or hyperkalaemia
2. For emergency treatment of hyperkalaemia
3. For treatment of arrhythmias, seizures or coma in overdose of cardioactive medications (e.g. tricyclic antidepressants, B blocker, digoxin)
4. To combat acidosis and hyperkalaemia in crush syndrome

Question 5

Sodium bicarbonate - Adverse effects (3)

Answer 5

1. Metabolic alkalosis
2. High sodium content may lead to fluid overload and cardiac failure
3. Interacts with some other drugs (especially calcium and adrenaline)
   - always flush well through the line before and after admin
   - consider a second line

Question 6

Sodium bicarbonate - Contraindication

Answer 6

Known hypersensitivity

Question 7

Sodium bicarbonate - Dose

Answer 7

Hyperkalaemia with cardiac output

• Adult & Paediatric
• 0.5mmol/kg IV over 2-5 min
• rep x 1 if req

Cardiac arrest

• Adult & Paediatric
• 0.5mmol/kg IV fast push
• rep x 1 if req

Cardioactive medication overdose

• Adult and paediatric - 12 lead with wide QRS complex
• 1mmol/kg until QRS is narrow
• rep as req.

Question 8

Sodium bicarbonate - Special note

Answer 8

Always administer sodium bicarbonate to cardioactive medication overdose pts when in cardiac arrest