SODIUM BICARBONATE

For intravenous administration only. 4% solution) given at 10 minute intervals. 4% solution should be diluted 1:1 with 5% dextrose. Elderly As for adults

Alkalosis and/or hypokalaemia may ensue as a result of prolonged use or over- correction of the bicarbonate deficit. Hyperirritability or tetany may occur caused by rapid shifts of free ionised calcium or due to serum protein alterations arising from pH changes.

Whenever sodium bicarbonate is used intravenously, arterial blood gas analysis, in particular arterial/venous blood pH and carbon dioxide levels, should be performed before and during the course of treatment to minimise the possibility of overdosage and resultant alkalosis.

Accidental extravascular injection of hypertonic solutions may cause vascular irritation or sloughing. The use of scalp veins should be avoided. Whenever respiratory acidosis is concomitant with metabolic acidosis, both pulmonary ventilation and perfusion must be adequately supported to get rid off excess CO2

3. Contra-indications Sodium Bicarbonate intravenous infusion is contra-indicated in cases of respiratory and metabolic alkalosis, hypoventilation, hypernatraemia, urinary calculi, potassium and chloride depletion, hypocalcaemia and in situations where supply of sodium is contra-indicated such as cardiac insufficiency, oedema, hypertension, eclampsia, renal impairment.