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Emergency Management of Hyperkalemia in Adults
Assess Patient - Airway Breathing Circulation Disability Exposure (ABCDE) Approach
 •
Management of Hyperkalemia ... mmol/L - Consider cause ... clinical scenario, ECG ... of hyperkalaemia ... recurrence #Hyperkalemia
BRASH Syndrome

B - Bradycardia
R - Renal failure
A - AV nodal blockade
S - Shock
H - Hyperkalemia

Typical ECG
S - Shock H - Hyperkalemia ... Typical ECG ... other findings of hyperkalemia ... of hyperkalemia ... ß blocker, or digoxin
Bradycardia Diagnostic and Management Algorithm

CONSIDER ETIOLOGY (not inclusive): 
 - STRUCTURAL: sick sinus, AV block, ischemia,
beta-blockers, digoxin ... LIFE THREATENING CAUSES ... & TREATMENT - ... channel blockers, digoxin ... Electrolytes (hyperkalemia
Digoxin Pharmacology and Pathophysiology
1) Na/K ATPase Pump - Digoxin works by directly binding to and inhibiting
Digoxin Pharmacology ... intracellular calcium causes ... - Hyperkalemia ( ... , in states of hypokalemia ... #Pharmacology #
Hyperkalemia - Diagnosis and Management - GrepMed Handbook

S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
Hyperkalemia - Diagnosis ... only if no clear cause ... emcrit.org/ibcc/hyperkalemia ... management of hyperkalemia ... #Hyperkalemia
Causes of Hyperkalemia - Intercellular Shift - Differential Diagnosis Algorithm
Transcellular Shift - Appropriate renal excretion (GFR,
Causes of Hyperkalemia ... • Cell Lysis (e.g ... -1 agonism • Digoxin ... #Hyperkalemia ... Diagnosis #Algorithm #Causes
Classification of Diabetes Insipidus

Central or neurogenic diabetes insipidus:
 - Congenital - Structural malformations affecting the hypothalamus
uropathy, Metabolic causes ... (e.g., hypokalemia ... , hypercalcemia) ... disease, Drugs (e.g ... Treatment is aimed
The chemical formula of Digoxin is C41 H64 O14.
Digoxin (Cardiac glycoside) reversibly inhibits the sodium-potassium-ATPase, causing
, hypokalemia, hypomagnesemia ... , hypercalcemia, ... Hypokalemia is a ... effect" on the ECG ... the successful treatment
Recurrent Polymorphic VT/Torsades de Pointes - Management Algorithm
Drugs that prolong QT interval:
 • Class 1a (quinidine,
Hypomagnesemia • Hypokalemia ... • Hypocalcemia ... (rarely) Treatment ... load: 25-50 mg/kg ... 1b (lidocaine)- case
Bradycardia - Differential Diagnosis 
 • Cardiac disease: Myocardial ischemia / infarction, Myocarditis, Congenital disorders, Cardiomyopathies,
. hyperkalemia) ... . digoxin, beta ... • Infections (e.g ... Physiological causes ... (e.g. athletes,