Anaphylaxis induced bradycardia, renal failure, AV-nodal blockade, shock, and hyperkalemia: A-BRASH in the emergency department

The emergency department (ED) is responsible for managing a variety of acute illnesses including undifferentiated shock. A newer less recognized syndrome termed BRASH – bradycardia, renal failure, AV-node blockers, shock and hyperkalemia – is a cycle of synergy between hyperkalemia and AV-blockade that can result in shock. This entity is more common amongst the elderly, considering polypharmacy and co-morbid diseases. Some cases have an inciting trigger of hy povolemia. Anaphylaxis is a potentially lethal form of shock that most emergency physicians (EP) treat in the ED.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research