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What is Sodium Bicarbonate?
The administration of bicarbonate may be considered if the pH remains below 7.1 or if hyperkalemia or tricyclic antidepressant overdose is suspected. It is given as an initial bolus of 50 mmol, further dosing would depend on the length of resuscitation and the arterial blood gases.
If the first three shocks are unsuccessful CPR is done for one minute. A further three shocks of 360 Joules are given after this. A further dose of adrenaline 1 mg is given every three minutes. This sequence is continued as shown in the left arm of the CPR algorithm. The number of times the cycle is repeated depends on clinical judgement and probability of successful outcome. Generally, as long as the rhythm remains VT/VF, there is a possibility of successful resuscitation.
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