Download CMG Pharmacology - Sodium Bicarbonate

SODIUM BICARBONATE
(Revised: January 2014)
TYPE:
Hypertonic alkaline solution; 8.4% Sodium Bicarbonate solution;
contains 1 mMol/ml Sodium & 1 mMol/ml Bicarbonate. [No schedule]
PRESENTATION:
50ml Sodium Bicarbonate solution, IMS Mini-jet
ACTIONS:
1. Neutralizes 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 seconds (IV)
USES:
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
cardio-active medications (e.g. Tricyclic antidepressant, B blockers
and Digoxin)
4. To combat acidosis and hyperkalaemia in crush syndrome.
ADVERSE EFFECTS:
1. Metabolic alkalosis
2. High Sodium content may lead to fluid overload & cardiac failure.
3. Interacts with some other drugs (especially Calcium & Adrenaline);
– always flush well through the line before & after administration
– consider a second line
CONTRAINDICATIONS: Known hypersensitivity
DOSE:
HYPERKALAEMIA:
Adult & paediatric (with Cardiac Output)
 0.5 mMol/kg IV over 2 – 5 minutes, repeat x 1 as required
IN CARDIAC ARREST:
Dose as above – given as fast push
CARDIO-ACTIVE MEDICATION OVERDOSE:
12 Lead with wide QRS complex:
 1mMol/kg until QRS complex is narrow
SPECIAL NOTE:
Always administer Sodium Bicarbonate to cardio-active medication
overdose patients when in cardiac arrest
ACT Ambulance Service Clinical Management Manual
Uncontrolled when printed. The latest version of this document is available on the ACT Ambulance Service internet site.
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