2016 Trumbull Protocol Book

Sodium Bicarbonate

Sodium Bicarbonate

Action

Onset

Reverses blood pH

Immediate

Indications Adult Pulseless Arrest Tricyclic Antidepressant Overdose (Adult and Ped)

Adult Dose Prolonged Cardiac Arrest: 1 mEq/kg IVP/IO of 8.4% Tricyclic Antidepressant Overdose: 1 mEq/kg IVP/IO of 8.4%

Pediatric Dose Pediatric Tricyclic Antidepressant Overdose: 1 mEq/kg IVP/IO 8.4% if > l1 lbs)

Contraindications Patients losing chloride by vomiting or continuous gastrointestinal suction, metabolic and respiratory alkalosis

Adverse Reactions Alkalosis and/or hypokalemia, extravasation of IV, tissue necrosis, ulceration, or sloughing at site

Precautions Overdose and alkalosis should be avoided, may cause vascular irritation or sloughing if given extravascularly, avoid scalp vein use. Risks of overdose and alkalosis should be avoided. Use caution in patients with CHF or other edematous sodium-retaining states.

Considerations Flush IV tubing before and after administration.

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EMR

EMT

AEMT

Paramedic

Extended