Sodium bicarbonate is no longer a first-line drug, because it worsens acidosis when administered in the presence of inadequate ventilation and perfusion. It is administered only after epinephrine administration has not improved a clinical situation. An initial dose of 1 meq/kg IV is given only after the airway has been secured, the patient hyperventilated, and CPR initiated. An exception may be a situation where hyperkalemia is a factor, and where metabolic acidosis is severe. Resuscitation drugs are ineffective in the face of severe acidosis and severe alkalosis. In neonates or premature infants, sodium bicarbonate should be diluted 1:1 with sterile water, not saline. Indications for bicarbonate use are the same as for adults.
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.