Evidence-Based Management Of Potassium Disorders In The Emergency Department
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Evidence-Based Management Of Potassium Disorders In The Emergency Department
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Publication Date: November 2016 (Volume 18, Number 11)

CME: This issue includes 4 AMA PRA Category 1 Credits™; 4 ACEP Category I credits; 4 AAFP Prescribed credits; and 4 AOA Category 2 A or 2B CME credits.

Authors

John Ashurst, DO, MSc
Director of Emergency Medicine Residency Research, Duke Lifepoint Conemaugh Memorial Medical Center, Johnstown, PA

Shane R. Sergent, DO
Department of Emergency Medicine, Conemaugh Memorial Hospital, Johnstown, PA

Benjamin J. Wagner, DO
Department of Emergency Medicine, Conemaugh Memorial Hospital, Johnstown, PA

Peer Reviewers

Camiron L. Pfennig, MD, MHPE
Associate Professor of Emergency Medicine, University of South Carolina School of Medicine; Emergency Medicine Residency Program Director, Greenville Health System, Greenville, SC

Corey M. Slovis, MD, FACP, FACEP
Professor and Chair, Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN

Abstract
 
Hypokalemia and hyperkalemia are the most common electrolyte disorders managed in the emergency department. The diagnosis of these potentially life-threatening disorders is challenging due to the often vague symptomatology a patient may express, and treatment options may be based upon very little data due to the time it may take for laboratory values to return. This review examines the most current evidence with regard to the pathophysiology, diagnosis, and management of potassium disorders. In this review, classic paradigms, such as the use of sodium polystyrene and the routine measurement of serum magnesium, are tested, and an algorithm for the treatment of potassium disorders is discussed.

Excerpt From This Issue

An elderly woman presents with 4 days of generalized weakness and fatigue secondary to diarrhea. On examination, she appears dehydrated. During your workup, you find that she is in acute renal failure and is suffering from hyperkalemia, with a serum potassium of 6.5 mEq/L. Her ECG shows mild peaked T waves. During discussion with the admitting physician, you are asked to give the patient sodium polystyrene. You seem to recall some controversy regarding this treatment and wonder if it is really indicated for this patient.

 

Product Reviews
Brenda Barnes, DPM - 11/08/2017
Great article
Katrina Anne Knowles, MD - 11/07/2017
Nephrology often requests Kayexalate prior to dialysis, but I will now discourage them from using it
Matthew Steele, MD - 11/06/2017
I will be more cautious using Bactrim/trimethoprim with patients that have known renal insufficiency, and give magnesium when administering potassium.
Francisco Gonzalez-Rosales, MD - 07/21/2017
Very good, to the point article

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