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 723: Nitro Drip in Flash Pulmonary Edema

Podcast 723: Nitro Drip in Flash Pulmonary Edema

Contributor: Alec Coston, MD Educational Pearls: Flash pulmonary edema or Sympathetic Crash Acute Pulmonary Edema (SCAPE) is a severe illness that requires aggressive treatment Often in patients with...

25 Loka 20215min

On the Streets #12: Salient Pre-hospital Considerations for Neurosurgical Emergencies - a Smorgasbord Part II

On the Streets #12: Salient Pre-hospital Considerations for Neurosurgical Emergencies - a Smorgasbord Part II

In this podcast, we are back again with host, Jordan Ourada, and neurosurgeon, Dr. Eddie Tsvankin as they discuss an exciting and mind-blowing array of topics pertaining to neurosurgery. Listen as Dr....

20 Loka 202147min

Podcast 722: Lower Extremity Dislocations

Podcast 722: Lower Extremity Dislocations

Contributor: Donald Stader, MD Educational Pearls: Hip Dislocation Prolonged dislocations can impair blood supply to femoral head Hip dislocation for >6 hours puts patient at high risk for needing ...

19 Loka 20216min

Podcast 721: Blakemore & Minnesota Tubes: Part II

Podcast 721: Blakemore & Minnesota Tubes: Part II

Contributor: Dylan Luyten, MD Educational Pearls: To place a Blakemore/Minnesota Tube: Insert into esophagus under visualization Inflate gastric port with 60 cc of air and obtain a chest xray to en...

18 Loka 20217min

On the Streets #11: Salient Pre-hospital Considerations for Neurosurgical Emergencies - a Smorgasbord

On the Streets #11: Salient Pre-hospital Considerations for Neurosurgical Emergencies - a Smorgasbord

On this episode of On The Streets, host, Jordan Ourada sits down with neurosurgeon/neurooncologist Dr. Eddie Tsvankin to discuss various topics concerning neurosurgery and how EMS workers in the field...

13 Loka 20211h 4min

Podcast 720: Blakemore & Minnesota Tubes: Part I

Podcast 720: Blakemore & Minnesota Tubes: Part I

Contributor: Dylan Luyten, MD Educational Pearls: Minnesota Tube has an extra port for suctioning otherwise is the same as a Blakemore Tube Indicated in MASSIVE upper GI bleeding often due to esophag...

12 Loka 20215min

Podcast 719: Normal Saline vs. Tap Water for Wound Irrigation

Podcast 719: Normal Saline vs. Tap Water for Wound Irrigation

Contributor: Ricky Dhaliwal, MD Educational Pearls: Multiple RCTs and a Cochrane Review found there is no difference in wound infection rates when irrigating with tap water  Pressure of the water and...

11 Loka 20213min

Podcast 718: Renal Failure Follow Up

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 ...

5 Loka 20213min

Suosittua kategoriassa Tiede

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