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Evidence suggests the reversal of toxic effects of CA (eg, QRS prolongation, myocardial depression) following serum alkalization and sodium loading with sodium bicarbonate.
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Alternatively, a bicarbonate infusion may be initiated after the bolus by adding 3 ampules of sodium bicarbonate (50 m Eq each for a total of 150 m Eq) to 1 L of 5% dextrose in water (D5W) and infusing at 1.5 - 2 times the maintenance rate.
The same maximum target blood p H of 7.50 - 7.55 should be used for bicarbonate infusions.
Endotracheal intubation is necessary in a patient who is obtunded and unable to protect the airway.
Intravenous access should be established as soon as possible.
The seizures in CA toxicity are usually self-limited.
The treatment of choice for prolonged or recurrent seizures in CA toxicity is a benzodiazepine.
Serum alkalinization with intravenous sodium bicarbonate has been the mainstay of therapy in CA-induced cardiovascular toxicity.
QRS prolongation is most often the indication for serum alkalinization in CA toxicity.
Serial ECG performed before and after administration of bicarbonate may be used to determine if cardiac conduction abnormalities are responsive to the therapy.
Boluses of sodium bicarbonate may be repeated to treat cardiac conduction abnormalities and impaired contractility, with a maximum target blood p H of 7.50 - 7.55.
Gastric lavage may be helpful in recovering and identifying the CA ingested.Tags: Adult Dating, affair dating, sex dating