Protocol Status: PUBLISHED
Protocol:
Version: 2026.01
Effective Date:
Last Reviewed:
Medical Director Approval:
Clinical Note: This content reflects current GCEMS clinical guidelines as of the dates listed above. If content appears inconsistent with current policy, use the most recent approved guideline and notify leadership for correction.

Sodium Bicarbonate

(NaHCO3)

 

Indications:

 

  • Severe Metabolic Acidosis
  • Cardiac Arrest (after ventilation problems are corrected)
  • Certain Medication Overdoses
  • Hyperkalemia

 

Contraindications:

 

  • CHF
  • Hypokalemia

 

Side Effects:

 

  • Metabolic Alkalosis
  • Increased Vascular Volume
  • Pulmonary Edema
  • Dysrhythmias through serum potassium depletion
  • Transiently raises the arterial PCO2

 

Adult Dose:

 

  • 1 mEq/kg IV/IO; may repeat 0.5 mEq/kg every 10 minutes

 

Pediatric Dose:

 

  • 1 mEq/kg IV/IO
  • Age ≤ 2 years; Must be diluted to 1:1 with D5W or Normal Saline prior to administration