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1/07/21 dc Sodium Bicarb
January 8, 2021

From: "David Collette" <david.collette@hhsys.org>
To: "grp allpharm" <grp_allpharm@hhsys.org>
Sent: Thursday, January 7, 2021 9:22:35 AM
Subject: sodium bicarb...again

Below is the email I sent out during our last big bicarb shortage...and it looks like we are headed that way again. Keith says that no 50 mL syringes or vials are avaialble. Please work with prescribers to ensure that usage conforms to the criteria listed below, noting htat bicard is NOT to be routinely used for Code Blue situations in adults. 

Sodium bicarbonate is once again on national backorder and we must take immediate steps to conserve our current supply for the most critical needs. The strict criteria for usage approved by P&T and MEC in November 2017 is still in effect and is as follows:

• Documented metabolic acidosis in critically ill patients, including bicarbonate drips in ICUs
• CV surgery
• High-dose methotrexate therapy
• Drug overdoses where alkalinization of the urine may be beneficial, including an overdose with a tricyclic antidepressant or aspirin
• Sodium bicarbonate injection is NOT approved for routine usage in Code Blue situations and will not be stocked in crash carts nor pharmacist code kits