Sodium Bicarbonate
GENERIC NAME
Sodium Bicarbonate
TRADE NAME
None
DESCRIPTION
Sodium bicarbonate is a salt that provides bicarbonate ions to buffer metabolic acidosis. It is used in several emergency situations, such as cardiac arrest, hyperkalemia, and tricyclic antidepressant overdose, to help restore acid-base balance.
HOW SUPPLIED
Prefilled syringe: 1 mEq/ml
INDICATIONS
- Tricyclic antidepressant overdose
- Suspected hyperkalemia
- Dialysis-related cardiac arrest
- Crush injury (Medical Control required)
- Cardiac arrest lasting longer than 10 minutes
CONTRAINDICATIONS
- Allergy or hypersensitivity to sodium bicarbonate
PRECAUTIONS
- Sodium bicarbonate precipitates with Calcium Chloride. Flush the IV line with 10 ml of Normal Saline between administering these two medications.
MECHANISM OF ACTION
Sodium bicarbonate increases the alkalinity of the urine to enhance the excretion of tricyclic antidepressants. It also acts as a buffer, helping to reduce acidosis in emergency situations.
SIDE EFFECTS
- Few side effects when used appropriately in emergency settings
AUTHORIZATION
Paramedic: Standing order
DOSAGE
| Patient Type | Route | Dosage | Maximum Dosage |
|---|---|---|---|
| All patients (except crush injury) | IV/IO push | 1 mEq/kg | Determined by patient response and clinical condition |
| Crush injury (Adult) | IV infusion | 1,000 ml of ½ Normal Saline with 100 mEq of Sodium Bicarbonate, infused over 1 hour | Medical Control required |
| Crush injury (Pediatric) | IV infusion | Consult Medical Control for dosing | Medical Control required |
Administration Notes:
- To prepare the infusion for crush injury, remove 100 ml from a 1,000 ml bag of Normal Saline, then inject 100 mEq of Sodium Bicarbonate and mix well.
- Monitor the patient’s electrolyte levels and acid-base status closely during administration.
- Adjust the dosage based on the patient’s clinical condition and response.