| Sodium Bicarbonate |
Mechanism of Action
Sodium Bicarbonate (NaHCO3)acts as a buffer agent by dissociating
to sodium and bicarbonate ions. In the presence of hydrogen ions,
the sodium and bicarbonate ions are converted to carbonic acid
(CO2) and released by the lungs.
The chemical reaction is as follows:
H+ + HCO3 <> H2CO3 <> H20 + CO2
Indications
Used in late-stage therapy in the arrest scenerio to control the
acid-base balance
Should be considered only after the more confirmed interventions,
i.e. defibrillation, intubation, compressions and other
pharmocologicals.
Used in tricyclic anti-depressant and phenobarbital overdose
Preexisting metaabolic acidosis
Hyperkalemia
Packaging
50 mEq in 50 ml
Drug box inventory = 2
Onset & Duration
Onset: 2-10 min
Duration: 30-60 min
Doses and Administration
IVP: 1.0 mEq/kg
Subsequent doses: half initial dose every ten minutes
Precautions
Not as effective of a buffer as good compressions/ventilations
CO2 may remain at the tissue level, resulting in a decrease in
myocardial conractility and resuscability
May cause intracerebral hemorrhage
Does not improve defibrillation success.
Must not come in contact with epinephrine, IV lines must be flushed.
Will increase the yellow color of a Nellcor EtCO2 detector
Pediatrics
Same dosing as adults
Sodium Bicarbonate (NaHCO3)acts as a buffer agent by dissociating
to sodium and bicarbonate ions. In the presence of hydrogen ions,
the sodium and bicarbonate ions are converted to carbonic acid
(CO2) and released by the lungs.
The chemical reaction is as follows:
H+ + HCO3 <> H2CO3 <> H20 + CO2
Indications
Used in late-stage therapy in the arrest scenerio to control the
acid-base balance
Should be considered only after the more confirmed interventions,
i.e. defibrillation, intubation, compressions and other
pharmocologicals.
Used in tricyclic anti-depressant and phenobarbital overdose
Preexisting metaabolic acidosis
Hyperkalemia
Packaging
50 mEq in 50 ml
Drug box inventory = 2
Onset & Duration
Onset: 2-10 min
Duration: 30-60 min
Doses and Administration
IVP: 1.0 mEq/kg
Subsequent doses: half initial dose every ten minutes
Precautions
Not as effective of a buffer as good compressions/ventilations
CO2 may remain at the tissue level, resulting in a decrease in
myocardial conractility and resuscability
May cause intracerebral hemorrhage
Does not improve defibrillation success.
Must not come in contact with epinephrine, IV lines must be flushed.
Will increase the yellow color of a Nellcor EtCO2 detector
Pediatrics
Same dosing as adults
