Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.

23Jan/122

Electrolyte Emergencies

John Marx, MD

  • For hyperkalemia, calcium chloride and gluconate (former contains 3x more Ca++ per amp) are the only agents that act directly on the heart. Multiple doses are often required. Treatment is usually indicated at levels 6.5 or higher.
  • The EKG changes in hyperkalemia are peaked T waves, small or indiscernible p waves, widening of the QRS and eventually a sinusoidal rhythm.
  • Hyponatremia can be categorized into the following; sample error, pseudo, hypervolemic, euvolemic and hypovolemic.
  • The treatment for hypernatriema is usually fluid restriction; for hyponatriema is usually NS.
  • The serum sodium goes down 1.6mEq per 100mg rise in glucose over 100.
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