REBEL Core Cast 109.0 – Na Channel Blocker Poisoning
REBEL Cast
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Treatment of Sodium Channel Blockade Poisoning with Sodium Bicarbonate
This chapter discusses the use of sodium bicarbonate in the treatment of sodium channel blockade poisoning, highlighting the importance of bedside observation, potential side effects, and key take-home points for management.
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Take Home Points: In the context of poisoning, a “wide QRS” is anything greater than 100 milliseconds. A newly “wide QRS”, especially with hemodynamic instability, should prompt consideration of sodium channel blockade and not ventricular tachycardia. Treatment is guided by administration of sodium-bicarbonate. Recall that the resultant alkalemia driven by sodium-bicarbonate will shift potassium intracellularly. ... 
