What Is the When, How and Why of Calcium and Cardiac Arrest?

This is a closed system. Cardiac arrest is the worst of the closed systems because there's actually an arterial venous dissociation. And you could try bagging that patient to get rid of excess CO2 and it does nothing to the venous side, which actually represents what the cells are seeing. So this is the least rationale based time to give bicarb. I don't think it works for any acidosis in which the patient can't blow off excess CO2,. But this is potentially the worst. Every bit of evidence on closed system bicarb shows no benefit. It is controversial still. Some intensivists seem to like it in certain patients with prolonged down times