SODIUM BICARBONATE

Sodium Bicarbonate

Reviewed by Dr Carl Kuschel
February  2001
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page

 

Management of  Sodium Bicarbonate Administration

Description

Prescription

Continuous IV infusion via syringe pump charted on fluid chart giving:

Also charted on drug chart under continuous infusions giving:

Administration

Slow IV Injection

  1. Administered by doctor / NS-ANP. In the emergency situation the nurse on the Neonatal IV Drug Register may administer under the direct supervision of the doctor present.
  2. Dilute prior to use 1:1 with sterile water for injection.
  3. Filter prior to administration through a 5 micron filter.
  4. Administer by slow IV injection. Rate not to exceed 1 mmol/minute.
  5. Incompatible with calcium. Compatible with NS, D5W, D10W.
  6. Stop IV fluids. Flush with NS before and after administration of sodium bicarbonate.

Slow IV Infusion

  1. Administered by a nurse with Neonatal IV Drug Certification.
  2. Dilute prior to use 1:1 with sterile water for injection.
  3. Filter prior to administration through a 5 micron filter.
  4. Administer by slow IV infusion over 30 minutes using a syringe pump.
  5. Incompatible with calcium. Compatible with NS, D5W, D10W.
  6. Flush with NS before and after administration of sodium bicarbonate.

Continuous IV Infusion

  1. Via syringe pump: Dilute prior to use on specific medical order.
  2. Via IV fluid bag: Add to IV fluids as ordered by medical staff (incompatible with calcium in solution).

Oral

  1. Give with feeds.

Observation and Documentation

  1. Monitor for adverse reaction
  2. Monitor acid-base status
  3. Include volume in daily fluid intake.

Storage

Selected References

1 Emergencies in the delivery room, in Fanaroff AA, Martin RJ (ed): Neonatal-perinatal medicine: disease of the fetus and infant, ed 4. St Louis, CV Mosby Co, 1988, pp336-378.
2 Howell JH. Sodium bicarbonate in the perinatal setting - revisited. Clin Perinatol 1987; 14:807.
3 Nairns RG, Cohen JJ. Bicarbonate therapy for organic acidosis: the case for its continued use. Ann Intern Med 1987; 106:615.
4 Roberts RJ. Drug therapy in infants: Pharmacologic principles and clinical experience. Philadelphia, WB Saunders Co, 1984, pp288-91.