Wide complex rhythm and cardiac arrest

Pang, Peter S.; Look, Rodney B.; Brown, David F.M.; Nadel, Eric S.

doi:10.1016/j.jemermed.2003.12.001

Cited by 7 publications

(6 citation statements)

References 10 publications

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“…Sinus rhythm with systolic blood pressure over 100 mmHg was restored. The patient was dialyzed and was discharged to home after a 1-week hospital stay with minimal short-term memory impairment [11].…”

Section: Discussionmentioning

confidence: 99%

Acute Oral Potassium Overdose: The Role of Hemodialysis

Platt

Anderson

Presley³

2010

J. Med. Toxicol.

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Section: Discussionmentioning

confidence: 99%

Acute Oral Potassium Overdose: The Role of Hemodialysis

Platt

Anderson

Presley³

2010

J. Med. Toxicol.

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“…The risks associated with this therapy should always be balanced with the potential benefits of IV calcium administration, keeping in mind it may not be indicated in all acute hyperkalemic patients. Although it is indicated for life-threatening ECG abnormalities even in the setting of unknown potassium concentrations, there is limited data as to whom would benefit from this therapy beyond this indication (Mahoney et al, 2005; Pang et al, 2004; Quick & Bastani, 1994; Soar et al, 2010). Some have suggested that in those presenting without ECG changes, regardless of potassium concentration, it may be reasonable to withhold calcium therapy as these patients are at a lower risk for subsequent hyperkalemia-induced ECG changes (Alfonzo et al, 2006; Durfey et al, 2017; Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, 2000; Heckler & McCraw, 1976; Montague et al, 2008; Pacheco Compana et al, 2017; Semple & Booth, 1996).…”

Section: Calciummentioning

confidence: 99%

Acute Hyperkalemia Management in the Emergency Department

Weant,

Gregory

2024

Advanced Emergency Nursing Journal

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Acute hyperkalemia is characterized by high concentrations of potassium in the blood that can potentially lead to life-threatening arrhythmias that require emergent treatment. Therapy involves the utilization of a constellation of different agents, all targeting different goals of care. The first, and most important step in the treatment of severe hyperkalemia with electrocardiographic (ECG) changes, is to stabilize the myocardium with calcium in order to resolve or mitigate the development of arrythmias. Next, it is vital to target the underlying etiology of any ECG changes by redistributing potassium from the extracellular space with the use of intravenous regular insulin and inhaled beta-2 agonists. Finally, the focus should shift to the elimination of excess potassium from the body through the use of intravenous furosemide, oral potassium-binding agents, or renal replacement therapy. Multiple nuances and controversies exist with these therapies, and it is important to have a robust understanding of the underlying support and recommendations for each of these agents to ensure optimal efficacy and minimize the potential for adverse effects and medication errors.

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“…It is usually effective within minutes, as noted by an improvement in the ECG appearance or reversal of ECG abnormality. It is generally accepted that intravenous (IV) calcium is indicated for potentially life-threatening ECG changes (absent P waves, wide QRS, sine-wave pattern), 10 , 18 , 20–22 arrhythmias, or cardiac arrest 23 . The dose can be repeated, if there is no effect within 5–10 min.…”

Section: Current Treatments Of Hyperkalaemiamentioning

confidence: 99%

Current treatment and unmet needs of hyperkalaemia in the emergency department

Rafique

Chouihed

Mebazaa

et al. 2019

European Heart Journal Supplements

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Hyperkalaemia is a common electrolyte abnormality and can cause life-threatening cardiac arrhythmia. Even though it is common in patients with diabetes, heart failure, and kidney disease, there is poor consensus over its definition and wide variability in its treatment. Medications used to treat hyperkalaemia in the emergent setting do not have robust efficacy and safety data to guide treatment leading to mismanagement due to poor choice of some agents or inappropriate dosing of others. Moreover, the medications used in the emergent setting are at best temporizing measures, with dialysis being the definitive treatment. New and old k binder therapies provide means to excrete potassium, but their roles are unclear in the emergent setting. Electrocardiograms are the corner stones of hyperkalaemia management; however, recent studies show that they might manifest abnormalities infrequently, even in severe hyperkalaemia, thus questioning their role. With an aging population and a rise in rates of heart and kidney failure, hyperkalaemia is on the rise, and there is a need, now more than ever, to understand the efficacy and safety of the current medications and to develop newer ones.

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Wide complex rhythm and cardiac arrest

Cited by 7 publications

References 10 publications

Acute Oral Potassium Overdose: The Role of Hemodialysis

Acute Oral Potassium Overdose: The Role of Hemodialysis

Acute Hyperkalemia Management in the Emergency Department

Current treatment and unmet needs of hyperkalaemia in the emergency department

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