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Bicarbonate, Sodium

* ACLS guidelines no longer include this as a part of resusitation unless there is hyperkalemia or pre-existing acidosis;
* Adult: based on blood gas values or empirically:
* Supplied: 50 ml vials (44 mEq/vial) (almost 1 mEq/ml)
* Dose 1 mEq/kg IV (50-100 mEq or 1-2 amp), then half the initial dose q10-15min; give undiluted 44.6 mEq or 50 mEq in 50 mL;
* Supplied: Injection 0.5 mEq/mL; tabs: 325-650 mg;
* Note: 1 gm neutralizes 12 mEq of acid;
* Note: must have effective ventilation; Base Deficit Stratifies Mortality and Determines Therapy.