Arrest Protocols

[emt4life]

Question for you all, do your services have standing orders for bicarb administration during a cardiac arrest?

I know we have a thread for bicarb, but its doesn't answer this question.

I am just curious if it is standing orders somewhere, because at both the services I work for it has to be ordered by medical control before we give it. I am just curious about its use across the country.

 

[Ridryder911]

We have standard protocols for almost everything. NaHc03 is administered by the discretion of the Paramedic of having a prolonged downtime in a cardiac arrest where the possibility of combination of respiratory and metabolic acidosis occur. Arrest where hyponatremia, or pH changes may occur (Dialysis patients) aspirin overdose, and rhabo episode.

R/r 911

 

[Epi-do]

While we do have bicarb on our trucks, it isn't in our arrest protocols to administer it.

 

[E in SD]

Im not yet in the field but Im constantly in the books and in my county (Ca) theres no Bicarb indicated for arrest, Just Epi and amiodarone (for this week at least)

 

[Ridryder911]

Actually Sodium Bicarbonate is part of the AHA ACLS protocol for * for consideration. Remember if the patient has been down more than 15 minutes, the patient might be metabolic acidotic and ventilation will not always correct it. As well, rad in "special considerations".. patients tat are electrolyte imbalanced, should be corrected. for example post dialysis patients.. I have actually seen them respond with bicarb and epi alone... if one does not administer it .. poor outcome.

R/r 911

 

[Airwaygoddess]

ACLS protocal

Sodium Bicarbonate is used in Santa Barbara County.

 

[BloodNGlory02]

We have to call med control for use.

 

[FFEMT1764]

We have bicarb here, and we can use it on any arrest that has been intubated for 10 minutes, prior to that we cant give bicarb. I have given bicarb on the past 2 arrests I worked. In both cases the bicarb helped a little, we got pulses back but once in the ER the doc didn't aggresively treat the patient, and well the outcome wasn't good.