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ECG Changes in Hyperkalemia and Treatment
Membrane Stabilization
 - Calcium gluconate or chloride 
Redistribution
 - Insulin
ECG Changes in Hyperkalemia ... and Treatment ... Hemodialysis #Hyperkalemia ... #Treatment #Management ... #EKG
Hyperkalemia on EKG
"Mild" Hyperkalemia
 • Peaked, narrow-based T Waves
 • Double counting of HR by EKG
Hyperkalemia on ... EKG "Mild" Hyperkalemia ... counting of HR by EKG ... widening • Sinus bradycardia ... #EKG #ECG #electrocardiogram
Emergency Management of Hyperkalemia in Adults
Assess Patient - Airway Breathing Circulation Disability Exposure (ABCDE) Approach
 •
Management of Hyperkalemia ... clinical scenario, ECG ... Gluconate IV Shift ... Consider cause of hyperkalaemia ... recurrence #Hyperkalemia
Hypokalemia - Differential Diagnosis Algorithm

Transcellular Shift:
 • Alkalosis
 • ↑ beta-2 adrenergic simulation 
 • Erythropoiesis
Hypokalemia - Differential ... Transcellular Shift ... Erythropoiesis (B12 injections ... Transcellular shifts ... MatthewHoMD #Hypokalemia
BRASH Syndrome

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

Typical ECG
Syndrome B - Bradycardia ... Typical ECG ... flattening of P waves (Bradycardia ... ) BRASH Treatment ... • Aggressive treatment
Overall schema for resuscitation of the bradycardic periarresting patient
A patient with bradycardic periarrest may be rescued
resuscitation of the bradycardic ... A patient with bradycardic ... medical therapy (e.g ... electrical therapy (e.g ... both types of treatments
Bradycardia - Differential Diagnosis Framework

BRADI Mnemonic
 • BRASH/Hyperkalemia
 • Reduced oxygen/Glucose/Temp
 • ACS
 • Drugs
 •
Mnemonic • BRASH/Hyperkalemia ... Drugs • ICP / Infections ... BRASH Syndrome - Hyperkalemia ... • Shock • Hyperkalemia ... Cimetidine Infections
Emergent Hyperkalemia Treatment Algorithm
ECG changes, weakness, K+ >6.5 Or renal insufficiency with K >5.5 with cellular
Emergent Hyperkalemia ... Treatment Algorithm ... PR, wide QRS, bradycardia ... cardiac membrane Shift ... not quickly) #Hyperkalemia
Bradycardia Diagnostic and Management Algorithm

CONSIDER ETIOLOGY (not inclusive): 
 - STRUCTURAL: sick sinus, AV block, ischemia,
Bradycardia Diagnostic ... dissection - INFECTIOUS ... THREATENING CAUSES & TREATMENT ... Electrolytes (hyperkalemia ... Diagnosis #Management #Bradycardia
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... • IV Fluids Shift ... LouLectures #Hyperkalemia