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 664: Rabies Prophylaxis

Podcast 664: Rabies Prophylaxis

Contributor: Jared Scott, MD Educational Pearls: 1-3 cases of rabies per year in US with 55,000 people per year receiving rabies prophylaxis 90% of rabies cases come from wildlife, most commonly by ...

27 Huhti 20215min

Podcast 663:  Down Syndrome

Podcast 663: Down Syndrome

Contributor:  Alicia Oberle, MD Educational Pearls: Down Syndrome with Trisomy 21 have three copies of chromosome 21 Current birth rates are around 1 in 700 births  Average life span 25 years in 1980...

26 Huhti 20213min

UnfilterED #13: Dr. Nadia Tremonti

UnfilterED #13: Dr. Nadia Tremonti

This week's episode features a fascinating conversation with Dr. Nadia Tremonti, medical director for the pediatric palliative care program at Children's Hospital of Michigan in Detroit. Dr. Tremonti ...

22 Huhti 20211h 3min

Podcast 662: Droperidol for Sedation

Podcast 662: Droperidol for Sedation

Contributor:  Aaron Lessen, MD Educational Pearls: Droperidol for sedation in agitated patients in the emergency department was studied compared to ziprasidone (Geodon) and lorazepam (Ativan) Double-...

21 Huhti 20213min

Podcast 661: Scalded Skin Syndrome

Podcast 661: Scalded Skin Syndrome

Contributor:  Ricky Dhaliwal, MD Educational Pearls: Primarily affects children Caused by staph aureus releasing exotoxins that result in erythema and sloughing of the skin Present with significant ...

20 Huhti 20212min

Podcast 660: Rhabdomyolysis

Podcast 660: Rhabdomyolysis

Contributor: Ricky Dhaliwal, MD Educational Pearls: Rhabdomyolysis occurs when high levels of myoglobin are released from dying muscle tissue into the blood Severe levels of myoglobin cause renal in...

19 Huhti 20215min

Podcast 659: Racial Bias in Pulse Oximetry

Podcast 659: Racial Bias in Pulse Oximetry

Contributor:  Aaron Lessen, MD Educational Pearls: Study in NEJM looked at occult hypoxemia, when oxygen saturation reads at >92% when the actual saturation is Rate of occult hypoxemia was 3 times h...

14 Huhti 20213min

Podcast 658: Febrile Seizures

Podcast 658: Febrile Seizures

Contributor: Peter Bakes, MD Educational Pearls: Febrile Seizure clinical criteria 6 months - 5 years of age Rapid rise in temp No preexisting seizure disorder No other explanation for the seizure...

13 Huhti 20214min

Suosittua kategoriassa Tiede

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