The Clinical Problem Solvers Episode 407: WDx #37: Clinical Unknown with Kaylin and Sharmin
Jul 10, 2025
Dr. Sukriti Banthiya, a first-year cardiology fellow at Henry Ford Providence, presents a riveting clinical case of a 78-year-old man facing severe challenges due to end-stage renal disease. The discussion navigates the complexities of managing cardiac arrest in such patients, including critical resuscitation techniques and the role of teamwork in emergencies. The nuances of diagnosing right-sided heart failure and pulmonary embolism are explored, highlighting the importance of tailored patient care and real-time decision-making in acute settings.
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Code Blue Basics
- In a code blue, first check the patient's code status and ensure proper monitoring setup.
- Use team knowledge and stay organized to manage the emergency effectively.
Managing Hyperkalemia and ECG
- Stabilize hyperkalemia with calcium, insulin, glucose, and bicarb while monitoring EKG changes.
- Perform bedside echo to assess for wall motion abnormalities and cardiac function.
Assessing Shock Etiology
- Low blood pressure with elevated jugular venous pressure and cool extremities suggest cardiogenic shock with possible right ventricular involvement.
- Shock etiology must consider cardiogenic, distributive, hypovolemic, and obstructive causes especially in dialysis patients.