EMS LHP - Episode 57 - Bicarb Use In Cardiac Arrest?

Y’all have had lots of questions about using sodium bicarbonate in cardiac arrest after we ran an interview with Dr. Menegazzi talking about an abstract he presented showing benefit with bicarb. You wanted more so here it is! Dr. Jarvis reviews a paper from British Columbia from 2017 that looks at just this thing!
If you like the show, please give us a 5-star rating wherever you get your podcasts.
Drop us questions/comments/suggestion for future pods at:
[e-mail]
@DrJeffJarvis
Citations:
1. Kawano T, Grunau B, Scheuermeyer FX, et al. Prehospital sodium bicarbonate use could
worsen long term survival with favorable neurological recovery among patients with out-ofhospital cardiac arrest. Resuscitation. 2017;119:63-69. doi:10.1016/j.resuscitation.2017.08.008

[@cm2973]

I recently got into a discussion about this on a social media page mostly populated by resuscitation minded folks. Unfortunately, nuanced discussion was beyond the admin.
This is a subject that truly needs more study to flesh out. That said, I don't know anyone who thinks blanket "for prolonged resucitation" use if BiCarb is a good idea. What may be reasonable is to treat known or suspected non-anion gap metabolic acidosis patients as a piece of their resuscitation.
"Bicarb bad" is incredibly low resolution; BiCarb should be used in specific instances only would be a much higher resolution take.

[@jimbollenbacher368]

Old habits die hard, sadly.

[@jeff698]

That they do. I can think of a number of habits I've had to kill off because of evidence. Pesky science. :)