BRASH Syndrome B - Bradycardia R - Renal failure A - AV nodal blockade S - Shock H - Hyperkalemia Typical ECG in BRASH: HR 30, peaked T waves, flattening of P waves (Bradycardia out of proportion to other findings of hyperkalemia) BRASH Treatment: • Aggressive treatment of hyperkalemia • Consider epinephrine (↑HR and drives K+ intracellularly) • If hypovolemic, give IV fluids ("balanced fluids" > normal saline) • If on a Ca2+ channel blocker, ß blocker, or digoxin, consider reversal strategy By Dr. Eric Strong @DrEricStrong #BRASH #Syndrome #diagnosis #management #pathophysiology