Is sodium bicarbonate (NaHCO3) a lifesaver or a risky move in Emergency Medicine? Explore this pivotal infographic from Dr. Salha Mohd Fadil, endorsed by the College of Emergency Physicians Malaysia. Based on the BICAR-ICU Trial and Surviving Sepsis Campaign 2021, discover when to act and when to hold back!
Routine use not recommended. Consider for hyperkalemia or drug overdose.
Reference: Lavonas, Eric J., et al. "2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." Circulation, vol. 148, no. 16, 17 Oct. 2023, pp. e153-e183, doi:10.1161/CIR.0000000000001161
Avoid for septic shock with lactic acidosis unless pH <7.2 and AKIN Score 2/3.
Reference: Evans, Laura, et al. "Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021." Critical Care Medicine, vol. 49, no. 11, Nov. 2021, pp. e1063-e1143. LWW Journals, doi:10.1097/CCM.0000000000005337
No overall benefit. Potential benefit in severe AKI, but needs more study.
Reference: Jaber, Samir, et al. "Sodium Bicarbonate Therapy for Patients With Severe Metabolic Acidaemia in the Intensive Care Unit (BICAR-ICU): A Multicentre, Open-Label, Randomised Controlled, Phase 3 Trial." The Lancet, vol. 392, no. 10141, 7 July 2018, pp. 31-40. DOI.org (Crossref), doi:10.1016/S0140-6736(18)31080-8
Share this critical guide with your EM team!
Dear all members of College of Emergency Physicians (CEP), future members and the whole fraternity of emergency medicine.
I would like to express my appreciation to all for supporting CEP all this while. During the last Annual General Assembly, a new team had been elected.
I am pleased that we have a dynamic and vibrant team. We have 7 new portfolios. Each of the presidents – past president, president and president-elect form 3 teams – red, yellow and green respectively. Each team will focus on the selected portfolios for stronger plan execution. Administratively, this shall be our way forward to facilitate execution of tasks.
We have very interesting projects lined up and for these, we shall need dynamic and strong members to come join in the taskforces or teams set up. We invite all of you in the fraternity of emergency medicine in Malaysia to come join us and be part of the team. This is how we make our presence felt and be the ones who ‘make things happen’.
We aim, during our office, to close all ranks, strengthen the fraternity and together move forward and beyond. In other words, the theme of the office is ‘Bridging Gaps and Breaking Barriers’.
For this, I would like to share a story of a ‘bridge builder’.
Once upon a time there was a carpenter. One day, a rich person called him and asked him to build a fence between his land and his neighbour’s whom he had a quarrel wth. A river was already separating the houses. The carpenter agreed. The owner had to leave outstation for a week. When he returned, he was angry that the carpenter, instead of building a fence, built a bridge. Nevertheless, he found that his children loved the bridge and even the neighbour’s kids crossed and played with his kids. Even his wife made friends with his neighbour’s. Because of all these, he too formed a friendship with his neighbour. He then called the carpenter and even wanted to pay him extra. The carpenter thanked him and said he had to leave. When asked where he was going, the carpenter said, “To build more bridges.”
So there you go. We have a lot of bridges to build – bridges of friendship, togetherness, oneness and much more. With the strength built in unity, we shall then break any barriers to fly high.
Let us all build these bridges together. Come join us and we shall make our fraternity a force to be reckoned with in Malaysia and the whole world is for us for the taking.
Bridging Gaps, Breaking Barriers
Datuk Dr Alzamani Mohammad Idrose
President of Malaysian College Of Emergency Physicians
