Sodium Bicarbonate

1. Therapeutic Effects
   1. Sodium Bicarbonate (NaHCO3) alters the blood pH.

2. Indications
   1. Acidosis in cardiac arrest after 15 minutes of witnessed arrest.
   2. Some cases in which severe metabolic acidosis is present.
   3. Tricylcic Antidepressant overdoses with symptomatic complications.

3. Contraindications/Precautions
   1. Witnessed arrest of less than 10 minutes.
   2. Pulmonary edema.
   3. Hyperventilation and increased tidal volume are more useful to expand atelectasis and thereby reverse metabolic acidosis.
   4. Use Sodium Bicarbonate sparingly.
   5. Do not administer with other medications in same IV line.

4. Side Effects
   1. Alkalosis
   2. Sodium and water retention
   3. Pain and irritation at infusion site.

5. Administration and Dosage
   1. Adult: 1 mEq/kg IV. Repeat every 15 minutes at 0.5 mEq/kg.
   2. Child: 1 mEq/kg IV. Repeat every 15 minutes at 0.5 mEq/kg.
   3. For Tricyclic antidepressant overdose: 1mEq/kg IV single dose by order from Medical Control.
   4. Requires adequate ventilation to provide benefit.