The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.
In the critically ill, severely acidotic patient, consider THAM.
In this section you note that you have to make sure the patient is ventilated in order to use bicarb, and you correctly mention separately you have to hyperventilate a patient. But, in the context of an arrest, it's important to remember that restrained respirations (8-10min) are indicated to minimize reductions in venous return/preload. These will not work well with attempts at using sodium bicarbonate (for this purpose). Though obviously the data are scarce, I think that if we follow the logic and physiology of THAM, it makes more sense for the intra-arrest patient.
Is anyone using THAM pre-RSI for the metabolic acidosis patient? Seems like on a simple level it could provide us an extra margin of safety
What you do matters.