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 generally depend on the serum level. Mild elevation may cause peaked T waves. At higher serum levels there will be loss of P waves plus wide complex tachycardia. There can be progression to fatal arrhythmias.
  • Treatment of acute hyperkalemia involves multiple mechanisms. Calcium gluconate stabilizes the cardiac membrane (of note, its duration of action is 1 hour). Insulin with Glucose and Bicarbonate both act to shift extracellular potassium into cells. Enhanced elimination of potassium is accomplished via Kayexalate or Lokelma. Definitive treatment for hyperkalemia is hemodialysis.
  • The differential for wide complex non-tachycardic rhythm on EKG includes: left ventricular hypertrophy, left bundle branch block, pacemaker, electrolyte abnormalities including hyperkalemia.

References

Palmer BF, Clegg DJ. Diagnosis and treatment of hyperkalemia. Cleve Clin J Med. 2017;84(12):934-942. doi:10.3949/ccjm.84a.17056

Watanabe R. Hyperkalemia in chronic kidney disease. Rev Assoc Med Bras (1992). 2020;66Suppl 1(Suppl 1):s31-s36. Published 2020 Jan 13. doi:10.1590/1806-9282.66.S1.31

Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD & 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(1144)

Podcast 896: Cancer-Related Emergencies

Podcast 896: Cancer-Related Emergencies

Contributor: Travis Barlock, MD Educational Pearls: Cancer-related emergencies can be sorted into a few buckets: Infection Cancer itself and the treatments (chemotherapy/radiation) can be immunos...

25 Maalis 20242min

Episode 895: Indications for Exogenous Albumin

Episode 895: Indications for Exogenous Albumin

Contributor: Travis Barlock MD Educational Pearls: There are three indications for IV albumin in the ED Spontaneous bacterial peritonitis (SBP) Patients with SBP develop renal failure from volu...

18 Maalis 20242min

Episode 894: DKA and HHS

Episode 894: DKA and HHS

Contributor: Ricky Dhaliwal, MD Educational Pearls: What are DKA and HHS? DKA (Diabetic Ketoacidosis) and HHS (Hyperosmolar Hyperglycemic State) are both acute hyperglycemic states. DKA More com...

11 Maalis 20247min

Episode 893: Home Treatments for Button Battery Ingestion

Episode 893: Home Treatments for Button Battery Ingestion

Contributor: Aaron Lessen MD Educational Pearls: Button batteries cause alkaline corrosion and erosion of the esophagus when swallowed Children swallow button batteries, which create a medical eme...

4 Maalis 20242min

Episode 892: Tourniquets

Episode 892: Tourniquets

Contributor: Ricky Dhaliwal, MD Educational Pearls: What can you do to control bleeding in a penetrating wound? Apply direct pinpoint pressure on the wound as well as proximal to the wound. Build ...

27 Helmi 20245min

Pharmacy Phriday #11: Riddles, Medical Jargon, NNT, and Time Travel

Pharmacy Phriday #11: Riddles, Medical Jargon, NNT, and Time Travel

Contributors: Kali Olson PharmD, Travis Barlock MD, Jeffrey Olson MS2 Summary: In this episode of Pharmacy Phriday, Dr. Kali Olson joins Dr. Travis Barlock and Jeffrey Olson in studio to discuss a var...

23 Helmi 202443min

Episode 891: Hypothermia

Episode 891: Hypothermia

Contributor: Taylor Lynch MD Educational Pearls Hypothermia is defined as a core body temperature less than 35 degrees Celsius or less than 95 degrees Fahrenheit  Mild Hypothermia: 32-35 degrees C...

19 Helmi 20244min

Podcast 890: Outdoor Cold Air for Croup

Podcast 890: Outdoor Cold Air for Croup

Contributor: Jared Scott MD Educational Pearls: Croup is a respiratory condition typically caused by a viral infection (e.g., parainfluenza). The disease is characterized by inflammation of the lary...

14 Helmi 20244min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
utelias-mieli
radio-antro
filocast-filosofian-perusteet
rss-laakaripodi
rss-sosiopodi
ihanat-ipanat
sotataidon-ytimessa
mielipaivakirja
rss-bios-podcast
rss-radplus
rss-opeklubi
rss-lihavuudesta-podcast