ECG diagnosis: hyperkalemia.

Joel T Levis, MD, PhD, FACEP, FAAEM, is a Senior Emergency Physician at the Santa Clara Medical Center, and Clinical Instructor of Emergency Medicine (Surgery) at Stanford University. He is the Medical Director for the Foothill College Paramedic Program in Los Altos, CA. E-mail: [email protected]. Figure 1. 12-lead ECG from an 82-year-old man with acute renal failure and hyperkalemia (serum potassium 8.6 mEq/dL). Demonstrates a ventricular junctional escape rhythm (41 beats/ min), with absence of P waves and peaked T waves.