REBEL Cast REBEL Core Cast 125.0 – Hyperkalemia
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Jun 26, 2024 Explore the critical steps for managing hyperkalemia in emergency care. Learn why an EKG is essential upon patient presentation, especially for those with renal issues. Discover the common causes, including medications and massive cell death, that lead to elevated potassium levels. Hear about the alarming cardiac effects and neuromuscular symptoms that can arise. The discussion emphasizes timely interventions like administering calcium salts for unstable patients, showcasing the urgency in tackling this common electrolyte disorder.
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Always Check EKG for Hyperkalemia
- Always consider pseudo-hyperkalemia when you see elevated potassium levels to prevent misdiagnosis.
- Obtain an EKG in all patients with ESRD or suspected hyperkalemia to detect cardiac effects early.
Variable ECG Manifestations
- Hyperkalemia ECG changes do not occur in a fixed order and can appear abruptly.
- Any unusual EKG changes should prompt consideration of hyperkalemia as a possible cause.
Stepwise Hyperkalemia Treatment
- For severe ECG changes from hyperkalemia, first give calcium salts to stabilize cardiac cells.
- Then use insulin with glucose and high-dose beta-agonists to shift potassium intracellularly, and prepare dialysis if needed for removal.
Take Home Points Always obtain an EKG in patients with ESRD upon presentation Always obtain an EKG in patients with hyperkalemia as pseudohyperkalemia is the number one cause If the patient with hyperkalemia is unstable or has significant EKG changes (wide QRS, sine wave) rapidly administer calcium salts In patients who are anuric, early mobilization ...