administration of sodium bicarb

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Who should give sodium bicarbonate? resident doctors or nurses? Because I'm quite confused about this matter. I used to work in a tertiary hospital and our nursing department is quite protective of us when it comes to administration of dangerous meds such as sodium bicarb and magnesium sulfate. Our level heads are fighting for our right to refuse to administer such meds if the resident on duty is around but if in case of emergency, a nurse supervisor who is very well knowledgeable about emergency nursing can administer the dose.

Right now, I just got started working in a smaller hospital in which they wanted me to administer sodium bicarb that is incorporated in a 1 liter PLR. She prepared it but she wanted me to hook it to the patient. So I refused.

Am I right or Is it just a matter of different policy per hospital regarding meds administration? who should give sodium bicarb? I fear that if I try to adopt on their style, I could harm a patient. HELP!:uhoh3:

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Specializes in ICU.

It is ok for the nurse to give sodium bicarb. Sometimes it is given IV push, and other times it is hung as a drip...depends on what it is needed for. I have never heard of the nurse not being able to give it.

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Specializes in Cardiac, ER.

I'm not sure what your concern is?

It's given frequently where I work and always by a nurse.

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I've never heard of a nurse not being able to give sodium bicarb either. i just gave some magnesium sulfate last night, through a central line of course, but we routinely push bicarb in codes.

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Specializes in Critical Care.
Who should give sodium bicarbonate? resident doctors or nurses? Because I'm quite confused about this matter. I used to work in a tertiary hospital and our nursing department is quite protective of us when it comes to administration of dangerous meds such as sodium bicarb and magnesium sulfate. Our level heads are fighting for our right to refuse to administer such meds if the resident on duty is around but if in case of emergency, a nurse supervisor who is very well knowledgeable about emergency nursing can administer the dose.

Right now, I just got started working in a smaller hospital in which they wanted me to administer sodium bicarb that is incorporated in a 1 liter PLR. She prepared it but she wanted me to hook it to the patient. So I refused.

Am I right or Is it just a matter of different policy per hospital regarding meds administration? who should give sodium bicarb? I fear that if I try to adopt on their style, I could harm a patient. HELP!:uhoh3:

I'm not really sure why you are so concerned about hanging sodium bicarb or mag sulfate. It is frequently given and in many facilities I've worked at both can be given in med/surg as well as tele and ICU. Every med we give can have an adverse outcome, the trick is to learn all you can about it before you administer it. What specifically is your fear? Might be able to help you if I understood your concern better.

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Specializes in ED, ICU, Heme/Onc.
I've never heard of a nurse not being able to give sodium bicarb either. i just gave some magnesium sulfate last night, through a central line of course, but we routinely push bicarb in codes.

We routinely hang mag riders in the ER, and will give it IVP during a code if the patient is in torsades. We also give bicarb IVP as a matter of routine too. I prefer a central line when giving these meds - even an amp of d50, but have learned to get it in where I can.

Blee

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Hi,

We routinely give bicarb when indicated. I have never heard otherwise. Not sure why there seems to be so much concern about hanging bicarb or magnesium?

I guess you might look at the indications for administration. Like in a code or prearrest situation, are you ACLS? Also, you have not indicated your level of licensure. That can make a difference as well in many states/hospitals.

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Specializes in ICU.

Im not sure why your concerned. As long as you know what the drugs are for, how to safely administer them and what the side effects are, it shouldnt be a problem. The problem might be that if you are not allowed to give IV push meds on your floor, and they ordered an IV push med, then the doc needs to give it. I work in ICU, so I dont know if its different, but I have pushed bicarb many many times. I have added it to the maintenance IV (usually D5W) many times and ran it that way too. As far as magnesium, its no different that say giving a potassium bolus. You dilute the magnesim in a mini bag or buretrol and run it over an hour or more. Why are you concerned that you giving any of these meds would harm your patient? As long as you follow the correct procedure, it shouldnt be a problem.

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Specializes in tele, oncology.

I give bicarb in fluids all the time, as well as mag riders. No one makes a big deal out of it, we seem to have to give the mag especially all the time (I'm on a tele floor).

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Specializes in Cath Lab, OR, CPHN/SN, ER.

We also had almost no problems with either drug.

The only time we had problems with Mag was if it was due to PTL and then we just wanted them out of the ER before delivering!

ETA- I don't ever remember seeing it given for PTL- we did our best to get them to L&D asap!

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Specializes in Cardiac Telemetry, ED.

We give bicarb all the time, too. We have a protocol, the bicarb is mixed in the main pharmacy, and the pharmacist calculates the drip rates and writes them in on the protocol sheet.

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Specializes in thoracic, cardiology, ICU.

I guess I'm with the others in not seeing the issue. At my facility on the floor we have mag sliding scales to keep the patients mag levels where we want them, same with potassium. they're given as boluses obviously and the concentrations depend on what kind of IV access the patient has. sodium bicarb is given for a variety of reasons as well without issue. I guess it'd depend on the reasoning for administering it.

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