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!

Avsnitt(1144)

Episode 987: Cough Suppressants

Episode 987: Cough Suppressants

Contributor: Meghan Hurley, MD Educational Pearls:  OTC Medications Dextromethorphan (DM) Most common OTC cough suppressant Minimal efficacy: Little evidence that it shortens the duration or severit...

15 Dec 20257min

Episode 986: Lateral Canthotomy in Emergency Settings

Episode 986: Lateral Canthotomy in Emergency Settings

Contributor: Taylor Lynch, MD Educational Pearls: What is orbital compartment syndrome, and how is it assessed in the emergency room? Orbital compartment syndrome (OCS) is an emergent ophthalmic cond...

8 Dec 20254min

Episode 985: Amiodarone vs. Lidocaine

Episode 985: Amiodarone vs. Lidocaine

Contributor: Aaron Lessen, MD Educational Pearls: How do amiodarone and lidocaine work on the heart? Amiodarone Blocks potassium channels (Class III effect). Also blocks sodium and calcium channels....

8 Dec 20252min

Episode 984: Fish Hooks

Episode 984: Fish Hooks

Contributor: Megan Hurley, MD Educational Pearls: Assess first: confirm the hook isn't near vital structures. Automatic subspecialty consult for eye involvement or proximity to carotid artery, radial...

24 Nov 20254min

Episode 983: Head-of-Bed Position in Large Vessel Occlusion Strokes

Episode 983: Head-of-Bed Position in Large Vessel Occlusion Strokes

Contributor: Aaron Lessen MD Educational Pearls:  Recent prospective randomized clinical trial assessed optimal head-of-bed positioning in patients with LVO 0º vs. 30º elevation Objective was to det...

18 Nov 20252min

Episode 982: Epistaxis Management

Episode 982: Epistaxis Management

Contributor: Meghan Hurley, MD Educational Pearls: 1. Initial Assessment Start with a physical examination: Determine if the bleed is anterior or posterior. Perform a primary survey: assess ai...

10 Nov 20256min

Episode 981: Electrical Burns

Episode 981: Electrical Burns

Contributor: Travis Barlock, MD Educational Pearls: Quick Statistics on Electrical Burns: Electrical burns compose roughly 2 to 9% of all burns that come into emergency departments. The majority of p...

3 Nov 20253min

Tox Talks 2025 Recap 1, Digoxin and Beta Blockers

Tox Talks 2025 Recap 1, Digoxin and Beta Blockers

Contributors: Preeya Prakash MD, Adam Greenhaw PharmD, Travis Barlock MD, and Jeffrey Olson MS4 In this episode, cardiologist Preeya Prakash and medical student Jeffrey Olson listen in as two cases ar...

29 Okt 202557min

Populärt inom Vetenskap

p3-dystopia
svd-nyhetsartiklar
pojkmottagningen
dumma-manniskor
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
rss-vetenskapsradion
rss-ufo-bortom-rimligt-tvivel
paranormalt-med-caroline-giertz
rss-experimentet
rss-vetenskapsradion-2
medicinvetarna
halsorevolutionen
bildningspodden
4health-med-anna-sparre
sexet
rss-spraket
vetenskapsradion
dumforklarat