When @EinsteinEMed residents tell me “the EKG doesn’t have any hyperkalemic changes” I ask them what the expected changes are. Everyone can tell me about peaked T waves, QRS widening and sine wave.
This is an EKG that we think of for hyperK @LITFLblog
THIS is one of the most common finding I have seen for severe hyperK. Residents commonly forget about PR prolongation, dropped P waves, junctional rhythm and bradycardia
https://litfl.com/hyperkalaemia-ecg-library/
HD pt p/w syncope and bradycardia. HR 17. Given calcium, insulin, dextrose with good response. Called the nephrologist at 2am:
Me: I have a patient who needs emergent HD. HyperK with initial HR 17
Nephro: Oh 70 isn’t bad. It can wait
Me: No. 1-7
Nephro: oh crap, that’s bad!
🙃
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