Emergency Medical Minute5 Loka 2021

Podcast 718: Renal Failure Follow Up

Contributor: Aaron Lessen, MD

Educational Pearls:

Patients with acute renal failure often need medical management for hyperkalemia
Those with severe electrolyte derangements or absent renal function may need emergent dialysis as well
Dialysis catheters are 12 or 14 french catheters placed in the right internal jugular or left subclavian
Placement is very similar to a central line or cordis catheter
Trialysis catheter is one option that has an extra port that can be used for regular medication administration and drawing blood
Do not default to use dialysis catheters for normal ED access due to risk of infection and clot development
While dialysis catheters are typically reserved for dialysis only, they can be used in extreme circumstances, such as a cardiac arrest

References

Co I, Gunnerson K. Emergency Department Management of Acute Kidney Injury, Electrolyte Abnormalities, and Renal Replacement Therapy in the Critically Ill. Emerg Med Clin North Am. 2019;37(3):459-471. doi:10.1016/j.emc.2019.04.006

Simon LV, Hashmi MF, Farrell MW. Hyperkalemia. [Updated 2021 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470284/

Akaraborworn O. A review in emergency central venous catheterization. Chin J Traumatol. 2017;20(3):137-140. doi:10.1016/j.cjtee.2017.03.003

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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