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Sodium Bicarbonate dilemma
Hello, I have a few questions about the administration of sodium bicarbonate in patients with metabolic acidosis, such as those with DKA or CKD. We're facing a dilemma regarding when to administer sodium bicarbonate. Should we base our decision on the clinical appearance of the patient or strictly on ABG or VBG results? What is the consensus on the pH level at which sodium bicarbonate should be given? Some sources suggest a pH of 6.9, while others, especially critical care colleagues, recommend administering it at a pH below 7.2. Additionally, some internal medicine colleagues suggest administering sodium bicarbonate based on clinical signs like Kussmaul respirations. Lastly, could you advise on the appropriate dosage of sodium bicarbonate? I apologize for the multitude of questions, and thank you in advance. I'm a big fan of your podcast!
PRE HOSPITAL CARE SETTINGS
Hi! I'm a new subscriber. I live in the Philippines. I really love your Rapid Bomb podcast. For the past 2 years we are being drilled with pre hospital care questions in our in service exam. Can you do some topics or high yield questions, or even study guides regarding PRE HOSPITAL CARE. Our training in EM residency here in the Philippines is purely Tintinalli based, other than our local guidelines. Thank you and more power to your podcast.