emDocs - December 19, 2019 - By Tyler Siekmann
..."Take Home Points:
- Sodium bicarbonate can be a useful therapy in toxic ingestions of multiple compounds including: sodium channel blocking agents, salicylates and toxic alcohols.
- Primary mechanisms of action include:
- Overwhelming of the sodium channel blockades
- Alkalizing serum and urine pH to limit toxicity and enhance elimination
- Treatment should be started with bolus dosing of 1-2 mEq/kg of 8.4% NaHCO3.
- Endpoints of treatment include: QRS < 100 msec, pH > 7.5, Na+ > 150mEq or clinical improvement."