Hi folks, these are the main points of our discussion in the last academic activity day, enjoy!
- Kayexalate,, Never think about it in the ED. Its effect -If any- only starts after 4 hours .
- There is some published evidence on severe GI complications secondary to the administration of Kayexalate such as colonic necrosis or perforation, whether accompanied with the administration of Sorbitol or not.
- Insulin with dextrose and Albuterol nebulizer have synergistic effect when treating hyperkalemia.
- In case of hypernatremia: Start with correcting the underlying shock, hypoperfusion or significant hypovolemia with normal saline.
- Most patients presenting to the ED with hyponatremia are stable and require NO emergent therapy.
- For asymptomatic patients with sodium values of 115 to 135 mEq/ L, free water restriction is typically the single most important treatment in ED.
- For Asymptomatic hyponatremia cases send: Serum and Urine osmolality, TSH, Random cortisol level, Uric Acid and urine electrolytes before starting fluids.
- Many case reports addressed fatality from iatrogenic hypermagnesemia in elderly ( with or without renal impairment). Dose and infusion rate should be reviewed cautiously.