Podcast 791: Hyperglycemic Hyperosmolar State

Podcast 791: Hyperglycemic Hyperosmolar State

Contributor: Aaron Lessen, MD

Educational Pearls:

  • Hyperglycemic Hyperosmolar State (HHS) is less common than Diabetic Ketoacidosis (DKA) but is associated with a mortality rate up to 10 times greater than that seen in DKA
  • Typically seen in elderly patients with severely elevated blood glucose levels (>1000 mg/dL) and an increased plasma osmolality
    • Unlike in DKA, patients with HHS do not have elevated ketones
  • Treatment of HHS includes insulin administration along with correcting fluid and electrolyte abnormalities
  • When treating HHS, it is important to monitor and follow osmolality regularly because over-rapid correction can result in the development of cerebral edema

References

Fayfman M, Pasquel FJ, Umpierrez GE. Management of Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. Med Clin North Am. 2017;101(3):587-606.

Gosmanov AR, Gosmanova EO, Kitabchi AE. Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext. South Dartmouth (MA): MDText.com, Inc. Copyright © 2000-2022, MDText.com, Inc.; 2000.

Long B, Willis GC, Lentz S, Koyfman A, Gottlieb M. Diagnosis and Management of the Critically Ill Adult Patient with Hyperglycemic Hyperosmolar State. J Emerg Med. 2021;61(4):365-375.

Summarized by Mark O'Brien, MS4 | Edited by John Spartz MS4 & Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.

Donate to EMM today!



Jaksot(1146)

Podcast 803:  Sedation During Intubation

Podcast 803: Sedation During Intubation

Contributor: Aaron Lessen, MD Educational Pearls: Awareness with recall of paralysis can occur in intubated and ventilated patients receiving paralytic medications  Patients who suffer from this eff...

8 Elo 20223min

Pediatric Palliative Care Expert Panel

Pediatric Palliative Care Expert Panel

Selected audio from our event, Palliative, hosted on June 27, 2022 in conjunction with Children's Hospital Colorado's Department of Palliative Medicine and The Denver Hospice's Footprints Program. Ke...

3 Elo 20221h 6min

Podcast 802: Intranasal Medication Administration for Pediatric Patients

Podcast 802: Intranasal Medication Administration for Pediatric Patients

Contributor: Aaron Lessen, MD Educational Pearls: Intranasal medication administration is a convenient, quick, and relatively painless option for pediatric patients Often used as an initial medicatio...

2 Elo 20223min

Mental Health Monthly #14: Substance-Induced Psychosis (Part II)

Mental Health Monthly #14: Substance-Induced Psychosis (Part II)

In this second episode of a two-part mini-series, we feature Dr. Nadia Haddad, a Colorado psychiatrist, and Dr. Ricky Dhaliwal, an emergency medicine physician, as they discuss the various treatment m...

27 Heinä 202224min

Podcast 801: Push Dose Vasopressors

Podcast 801: Push Dose Vasopressors

Contributor: Aaron Lessen, MD Educational Pearls: There are two common options for push-dose vasopressor: phenylephrine and epinephrine. Both have been studied in the setting of the OR, but are lacki...

26 Heinä 20223min

Podcast 800: Mortality in Fevers

Podcast 800: Mortality in Fevers

Contributor: Aaron Lessen, MD Educational Pearls: A recent study evaluated the association between the degree of fever and mortality rate in patients presenting to a set of Emergency Departments in I...

25 Heinä 20222min

Podcast 799: EKG Abnormalities in Renal Failure

Podcast 799: EKG Abnormalities in Renal Failure

Contributor: Peter Bakes, MD Educational Pearls: Patients in renal failure may have elevated serum potassium levels which can result in EKG changes. EKG changes in the setting of hyperkalemia gener...

19 Heinä 20224min

Podcast 797: Vitamin C in Sepsis

Podcast 797: Vitamin C in Sepsis

Contributor: Aaron Lessen, MD Educational Pearls: Prior, smaller studies showed intravenous Vitamin C given to patients with sepsis significantly improved patient mortality and additional outcomes. ...

12 Heinä 20222min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
utelias-mieli
rss-astetta-parempi-elama-podcast
filocast-filosofian-perusteet
rss-lapsuuden-rakentajat-podcast
rss-sosiopodi