ER Hall of Fame
I can't believe we don't have a hall of fame thread for extreme lab values. Highest and lowest potassium, pH and the like. I'll start by nominating my patient for today who is walking and talking with a blood alcohol of ....
710 Hooray! He has been training like an Olympic athlete for many years to achieve this level of greatness. What a stallion!
ETOH = 710 (Source: Student Doctor Network)
Source: Student Doctor Network - February 27, 2023 Category: Universities & Medical Training Authors: docB Tags: Emergency Medicine Source Type: forums
Highest/lowest electrolytes you've seen?
Had a bit of a surprise a while back. Generic outpatient eye surgery, doesn't tolerate MAC so we do general with LMA. Super brady during the case, refractory to usual interventions (glyco, atropine, ephedrine, 10-20mcg dose EPI, surgeon stops touching eye for a while). Starts having some junctional beats with HR down to 20s. Pads put on to pace if needed. Surgery aborted.
PACU, his potassium level is 8.0! That is probably the highest serum potassium I've ever seen on a patient who...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - October 20, 2021 Category: Universities & Medical Training Authors: abolt18 Tags: Anesthesiology Source Type: forums
How fast do you run potassium?
oh my gosh, an actual pharmacy question - lol
How fast does your insitution allow KCL to be run?
In the CC forum I had a doc tell me they allowed up to 50 or 60 meq an hour based on access. I told them 20 meq is our max - and I believe it is the common max at most places (but I have only worked as a rph at two hospitals so my experience with others is limited). Also, it doesn't matter access as far as rate and cardiac safety (access only allows a higher concentration/less burning).
thanks (Source: Student Doctor Network)
Source: Student Doctor Network - June 27, 2021 Category: Universities & Medical Training Authors: Dred Pirate Tags: Pharmacy Source Type: forums
Hyperkalemia, Compartment Syndrome
One of my on-call cases from the past year:
Middle aged guy without any known medical history who passed out after taking heroin, alcohol and cocaine woke up less than 12 hours later unable to move his left leg and right arm. Brought to ER by ambulance. Found to have potassium level over >10, tall peaked T-waves and widened QRS. In the ER received aggressive IV hydration, calcium gluconate, insulin/glucose, lasix, mannitol, albuterol, bicarbonate, was also briefly on pressors for...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - February 3, 2021 Category: Universities & Medical Training Authors: coffeebythelake Tags: Anesthesiology Source Type: forums
Why does IV potassium burn?
I've been asked this question on rotation and I've run some pubmed searches and haven't been able to find anything! It's driving me crazy. Is it tonicity?
Does anyone know the answer or at least know where to direct me to find it?
Thanks! (Source: Student Doctor Network)
Source: Student Doctor Network - August 30, 2020 Category: Universities & Medical Training Authors: Cocogirl Tags: Pharmacy Source Type: forums
TEE case - Is this tamponade?
I'm going to keep the details purposefully light until we get some responses. Let's see what everyone thinks just based on:
24yo M trauma pt
No significant PMH
Inciting incident happened about 12 hours ago. Pt drove himself to an OSH about 3-4 hrs ago. He's now been transferred to us.
PE:
NAD. Ox3 but a little drowsy
HR 82
BP 155/73 by a-line. A bit of respiratory variation is seen
SpO2 99 on RA
Hgb borderline low, potassium is a little elevated
GETA is induced by one of your...
TEE case - Is this tamponade? (Source: Student Doctor Network)
Source: Student Doctor Network - August 2, 2020 Category: Universities & Medical Training Authors: vector2 Tags: Anesthesiology Source Type: forums
Inappropriate data analysis leads to misleading results on the association between sodium and potassium intake and cardiovascular outcomes
(Source: BMJ Comments)
Source: BMJ Comments - March 22, 2019 Category: General Medicine Source Type: forums
Re: Joint association of urinary sodium and potassium excretion with cardiovascular events and mortality: prospective cohort study
(Source: BMJ Comments)
Source: BMJ Comments - March 16, 2019 Category: General Medicine Source Type: forums
Conn Syndrome
How does Conn Syndrome (primary hyperaldo) cause hypertension if you have normal Na+ (via the aldo escape mechanism)? According to Goljan, htn is always assoc with increased Na+. Just had a Uworld question that stated a pt with hypertension due to conn syndrome has nL sodium, low potassium and high bicarb. I just dont get how you can have htn with normal sodium. Thanks!! (Source: Student Doctor Network)
Source: Student Doctor Network - April 19, 2018 Category: Universities & Medical Training Authors: imtheman25 Source Type: forums
Highest Boiling Point
Which solution has the HIGHEST boiling point? (Berkeley Review Gen Chem. Part 2, page 90, example 7.16)
A.) 0.10 moles magnesium chloride in 100 mL water
B.) 0.15 moles lithium bromide in 150 mL water
C.) 0.20 moles sodium iodide in 100 mL water
D.) 0.25 moles potassium fluoride in 150 mL water
The answer is "C'. I put "A". I used the formula for finding the increase in boiling point when solute is added to a solution: Delta Tb = kb*i*m
I calculated the (i*m) values for each of the...
Highest Boiling Point (Source: Student Doctor Network)
Source: Student Doctor Network - January 4, 2018 Category: Universities & Medical Training Authors: Umyo Source Type: forums
Re: Sixty seconds on . . . potassium
(Source: BMJ Comments)
Source: BMJ Comments - December 10, 2017 Category: General Medicine Source Type: forums
Potassium Products
There are so many potassium products out there. Is there a resource, other than orange book, that has concise, easy to access information on which products are interchangeable with others? Thank you. (Source: Student Doctor Network)
Source: Student Doctor Network - November 20, 2017 Category: Universities & Medical Training Authors: baronzb Source Type: forums
Excitability of the nerve and potassium ion concentration.
My book says that the excitability of the nerve is increased when increasing the the potassium ion (K+) concentration in the extracellular fluid and vice versa.
I don't understand this mechanism could someone explain it for me!
Thanks in advance! (Source: Student Doctor Network)
Source: Student Doctor Network - November 16, 2017 Category: Universities & Medical Training Authors: Akam ahz Source Type: forums
Nurse overdocumentation
Does anyone have to deal with nurses that document every little encounter or change that involve you as a physician? For example, I have to deal with a lot of nurses who document things like, patient's potassium was 3.1, per Dr. X, will administer Kdur. Or patient's urinary output has been progressively decreasing over the last 4 hours, per Dr. Y, will continue to monitor.
Or something like that. It just feels like nurses want to be free of any responsibility/blame if things go wrong, even...
Nurse overdocumentation (Source: Student Doctor Network)
Source: Student Doctor Network - September 14, 2017 Category: Universities & Medical Training Authors: Hemichordate Source Type: forums
