Sodium Bicarbonate 8.4%
 
Presentation
• 50ml prepared syringe (Sodium Bicarbonate 8.4%)
Pharmacology
• A hypertonic crystalloid solution
• Contains sodium and bicarbonate ions in a solution of high pH
Actions
• Raises pH
Metabolism
• Sodium: Excreted by the kidneys
• Bicarbonate: Excreted by the kidneys as bicarbonate ion, and by the lungs as carbon dioxide
Primary Emergency Indications
• To reduce metabolic acidosis during cardiopulmonary resuscitation after 15 minutes of Ambulance personnel CPR Adult Paed
• Symptomatic Tricyclic Antidepressant Overdose Adult Paed
Contraindications
• Nil of signifcance in the above indications
Precautions
• Administration of Sodium Bicarbonate 8.4% must be accompanied by effective ventilation and External Cardiac Compression if required
• Since Sodium Bicarbonate 8.4% causes tissue necrosis, care must be taken to avoid leakage of the drug into the tissues
• Because of the high pH of this solution do not mix or fush any other drug or solution with Sodium Bicarbonate 8.4%
Route of Administration
• IV
Side Effects
• Sodium overload may provoke pulmonary oedema
• Excessive dosage of Sodium Bicarbonate 8.4%, especially without adequate ventilation and circulation may cause an intracellular acidosis.
Special Notes
 
Therapeutic Effect
IV     
Onset:
1-2min
Peak:
Duration:
Depends on cause and Pt’s perfusion