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Insulin Hyperkalemia Mechanism

Hyperkalemia In Emergency Medicine

Hyperkalemia In Emergency Medicine

Practice Essentials Hyperkalemia can be difficult to diagnose clinically because symptoms may be vague or absent. The fact, however, that hyperkalemia can lead to sudden death from cardiac arrhythmias requires that physicians be quick to consider hyperkalemia in patients who are at risk for it. See the electrocardiogram below. See also Can't-Miss ECG Findings, Life-Threatening Conditions: Slideshow, a Critical Images slideshow, to help recognize the conditions shown in various tracings. Signs and symptoms Patients with hyperkalemia may be asymptomatic, or they may report the following symptoms (cardiac and neurologic symptoms predominate): Evaluation of vital signs is essential for determining the patient’s hemodynamic stability and the presence of cardiac arrhythmias related to hyperkalemia. [1] Additional important components of the physical exam may include the following: Signs of renal failure, such as edema, skin changes, and dialysis sites, may be present Signs of trauma may indicate that the patient has rhabdomyolysis, which is one cause of hyperkalemia See Clinical Presentation for more detail. Diagnosis Laboratory studies The following lab studies can be used in the diagnosis of hyperkalemia: Potassium level: The relationship between serum potassium level and symptoms is not consistent; for example, patients with a chronically elevated potassium level may be asymptomatic at much higher levels than other patients; the rapidity of change in the potassium level influences the symptoms observed at various potassium levels Calcium level: If the patient has renal failure (because hypocalcemia can exacerbate cardiac rhythm disturbances) Urinalysis: To look for evidence of glomerulonephritis if signs of renal insufficiency without a known cause are present Cortisol a Continue reading >>

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