I need a reference to create a policy for Na Bicarb instillation to treat a dilantin precipitae. I have the new INS standards in front of me but the refences refer to tpa, ethanol and HCL.
I have only seen this in the Oncology Nursing Standards.
Do you have that standard?
The articles referenced in Standard 56, Practice Criteria F provide you with a discussion of alteration of pH by using either Na Bicarb or hydorchloric acid. These discussions are based in basic chemistry. Phenytoin has a pH of 11-12 or highly alkaline. Precipiate occurs because that high pH has dropped. To reverse the precipitate, you raise the pH with bicarb. I don't think you will find any actual clinical studies reporting the outcomes of the use of each solution. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Office Phone 770-358-7861