Intravenous Administration of 8.4% Sodium Bicarbonate (One Ampoule)
An ampoule of 8.4% sodium bicarbonate is administered by the intravenous route. [1] The labeled strength commonly corresponds to 50 mEq contained in 50 mL (1 mEq/mL). [1]
Route and Access
Intravenous sodium bicarbonate is administered preferably via a central line. [2] Extravasation must be avoided due to hypertonicity and local tissue injury risk. [2]
Bolus Administration for Cardiac Arrest
In cardiac arrest, a rapid intravenous dose of one 50 mL vial (44.6 mEq) may be given initially. [1] The dose may be continued at 50 mL (44.6 to 50 mEq) every 5 to 10 minutes if necessary, guided by arterial pH and blood gas monitoring. [1]
Bolus Administration Requirements
Rapid administration requires caution because very rapid infusion of large quantities can produce hypernatremia from the sodium load. [1] Adequate alveolar ventilation should be ensured during administration because bicarbonate therapy is followed by release of carbon dioxide. [2]
Monitoring During Administration
Arterial blood pH and blood gas monitoring should be used to indicate whether additional bicarbonate dosing is necessary during treatment of acidosis. [1]
Handling and Disposal
The injection is for single-patient use on one occasion, and unused portions should be discarded. [2]