Sodium Bicarbonate Flashcards
Trade name
Sodium Bicarbonate 8.4%
Class
Buffer, Alkaline agent
Mechanism of action
Reacts with hydrogen ions to form water and carbon dioxide thereby acting as buffers for metabolic acidosis and increases ph. Rapid onset of action in the blood. Delayed onset of action in the tissues
Indications
Pre-existing metabolic acidosis; overdose of asprin, cyclic antidepressants (alkalization of blood); cardiac arrest after other interventions and ventilation is adequate, hyperkalemeia
Contraindications
Alkalosis; non-patent vascular access
Adverse effects
Congestive heart failure, edema secondary to sodium overloads; hyperosmolarity, metabolic, alkalosis, hypernatremeia, in cardiac arrest may cause extracellular alkalosis and intracellular acidosis; digitalis excess hypokalemia from sodium bicarbonate administration may worsen dysrhythmias
Incompatibilities/ Drug interactions
Must flush line before and after administration all drugs
Routes of admin
IV/IO
Onset of action
Onset: seconds, peak effect 1-2min, duration 10min
Adult dose
1mEq/kg IV
Pediatric dose
1mEq/kg IV
Special considerations
Flush tubing before and after administration, especially with concurrent use of calcium chloride
Sodium bicarbonate administration should be considered only for treatment of documented severe acidosis associated with prolonged cardiac arrest or an unstable hemodynamic state , hyperkalemia or certain overdoses (cyclic antidepressants, ASA, phenobarbital, etc)
Severe tissue necroses will occur with extravasation, asses for IV patentcy
Protocols used
A-8: Asystole/PEA A-10: VF/VT A-15: Environmental emergencies A-22: overdose A-25: Psychiatric/ behavioral emergencies A-26: special considerations for renal pts B-6: Pediatric Asystole/PEA B-7: Pediatric VF B-20: Pediatric Drowning C-7: Crush injuries E-23: Field prisoner control
