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Sodium bicarbonate is well recognised in the treatment of tricyclic overdose. But its use in the treatment of massive β blocker (propanol) overdose has not been previously reported.
CASE REPORT
A 24 year old woman presented to the accident and emergency department with a history of overdose, taking 92 propanolol LA 80 mg, 45 paroxetine 30 mg, and 28 diazepam 5 mg tablets, two hours before admission. NPIS advised us to give activated charcoal every four hours and monitor vital signs closely and if needed intravenous glucagon. Within 30 minutes of arrival however her Glasgow Coma Score deteriorated rapidly and she developed hypotension. Arterial blood gas measurements showed metabolic and lactic acidosis. She rapidly deteriorated and went into cardiorespiratory arrest. She was intubated and standard ALS...