Under which conditions should Sodium Bicarbonate be administered in TCA overdose cases?

Sodium Bicarbonate administration in cases of TCA (tricyclic antidepressant) overdose is indicated under specific clinical conditions that reflect significant cardiac toxicity. The correct answer highlights the necessity for both a heart rate exceeding 120 beats per minute and a QRS duration greater than 0.12 seconds.

In TCA overdose, one of the major risks is the development of serious cardiac arrhythmias, often due to sodium channel blockade that can lead to widened QRS complexes and tachycardia. A heart rate greater than 120 can indicate tachyarrhythmias, which increases the risk of hemodynamic instability. Additionally, when the QRS duration exceeds 0.12 seconds, it suggests that there is significant conduction delay, which can also predispose the patient to potentially life-threatening arrhythmias.

When both of these conditions are present, it signifies that the patient is at high risk of developing severe cardiac complications. By administering Sodium Bicarbonate, clinicians can help to correct metabolic acidosis and also stabilize cardiac function, as it works to enhance the pH and can help mitigate harmful effects on the myocardium. Thus, the comprehensive approach to the use of Sodium Bicarbonate encompasses the identification of critical changes in the patient's cardiovascular