hyperkalemia

Now, this is the audio version of the past week's summaries, which this week were brought to you by our authors, Jason Lesnick, Katherine Sulkowski, Rebecca DeFabio, Joshua Belfor, Colin O'Shea, Amanda Matthews, and Clay Smith.

Okay, let's talk about the first article titled, "The Diagnosis and Management of Acute Hyperkalemia" out of the BMJ.

Now, hyperkalemia, we worry about this a lot.

High potassium is one of the most deadly and one of the most common electrolyte disturbances, and it's definitely one that we talk about the most.

contributions.

In a contribution entitled, Hypokalemia and Hyperkalemia in Heart Failure, Risk Factor or Risk Marker? By Lars Lund and Barnas Thabor Söderberg from Karolinska Institute in Stockholm, Sweden.

Comment on the recently published paper entitled, Optimal Serum Potassium Concentrations in Heart Failure an Individual Patient Data Meta-Analysis by Rihoy Ono et al.

from the University of Glasgow in the United Kingdom Ono and colleagues reply in a separate

Brugada pattern.

Hyperkalemia.

Takotsubo cardiomyopathy, which can mimic anterior infarction almost perfectly.

My advice is simple: Reciprocal ST depression in the opposite leads strongly favors infarction.

Think of the catheterization laboratory.

Let's move on to the metabolic and toxic emergencies.

Hyperkalemia first.

Hyperkalemia is one of the most important ECGs in critical care because it kills quietly and because the ECG may be the first clue before the laboratory report arrives.

Adverse effects.

Hyperkalemia, of course, because it makes you hold on to potassium.

We might overcorrect the problem, right? Yeah, we wanted them to hold on to potassium, but now we overcorrected it.

Now they got hyperkalemia.

That definitely is an adverse effect.

Hyperkalemia, which could cause lethargy, confusion, ataxia.

You know ataxia, when they're walking like they're drunk? Ataxia, muscle cramps, and cardiac, page 902, cardiac arrhythmias.

Look what I put next to it, NCLEX.

You know, it can cause cardiac arrest.

It is very serious if we see hyperkalemia in the emergency department.

Hyperkalemia is just a fancy way of saying high potassium.

But this is the most important thing.

It is pretty much impossible to push your potassium into that danger zone through eating vegetables alone.

The final crisis of a major burn is the profound electrolyte chaos, specifically the terrifying spike in potassium.

Hyperkalemia.

Let’s look at the cellular level here.

Under normal physiological conditions, the sodium-potassium pump actively works to keep sodium outside the cell and potassium heavily concentrated inside the cell.

And if the potassium isn’t rapidly driven back into the cells using therapies like IV insulin and glucose, what happens?

The heart will simply stop.

Hyperkalemia triggers lethal ventricular arrhythmias, specifically ventricular fibrillation or asystole.

So you aren’t just treating burned skin.

The increased oxygen demand of the muscles and increased buildup of CO2 causes tachycardia.

Hyperkalemia leads to cardiac arrhythmias.

Myoglobin damages the kidneys, leading to acute renal failure.

And the hypermetabolic state causes body temperature to increase, which leads to widespread organ dysfunction and DIC.