Hyperkalemia is a common electrolyte abnormality frequently complicated with chronic kidney disease. By injecting potassium chloride (KCl) solutions intravenously into bullfrogs, we reproduced typical electrocardiogram (ECG) abnormalities of hyperkalemia in the frog hearts, such as peaked T waves and widening QRS complexes. Simultaneous recordings cardiac action potentials showed morphological ...

To the Editor-The appropriate review, "Anesthesia for Major Thermal Injury," overstates the contraindication to succinylcholine on pages 754 (". . . succinylcholine . . . >24 h after burn injury is unsafe") and 755 (". . . safe only within 24 h of a burn").' The safe period for burn patients is 6-7 days after a burn injury, whereas that for denervation is 4 days. Studies beginning 6 days after ...

A 22-year-old male was brought in by paramedics who found him unresponsive at home surrounded by drug paraphernalia. He had a blood pressure of 84/50 mm Hg; oxygen saturation of 88%; irregular pulse; and Glasgow Coma Scale of 3. His skin was cool, diaphoretic and ashen in color, except for a grossly erythematous right arm. Lab work demonstrated an initial creatine kinase of 5,414 U/L that incre...

A 47-year-old homeless man with a history of bipolar disorder and polysubstance abuse was found under a bridge with altered mental status and severe left calf pain. Evaluation in the emergency department revealed a cachectic, pale man with a blood pressure of 132/84, pulse 74, and respirations 18. He was afebrile. Oxygen saturation was 98% on room air. Examination revealed marked swelling of th...

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: joel.levis@kp.org. Figure 1. 12-lead ECG from an 82-year-old man with acute renal failure and hyperkalemia (serum pot...

This case report describes the management of a middle-aged hypertensive male patient who presented with acute inferior ST-segment elevation myocardial infarction accompanied with severe hyperkalemia. His coronary angiography revealed a thread like right coronary artery along its entire course and normal left coronary artery system with patent coronary stents in the left anterior descending and ...

Essential thrombocythemia is very rare during childhood. The pseudo-electrolyte imbalances including hyperkalemia and hypercalcemia have been reported among adult patients with this condition. Due to the rarity of this condition in the pediatric age group, overtreatment and even hospitalization of these patients for correction of electrolyte imbalances is usually inevitable. Herein, we reviewed...

In patients with end-stage renal disease (ESRD), the intestinal tract may assume an accessory potassium (K) excretory role in the face of declining renal excretory function. Here, we report the case of a patient with ESRD who developed severe hyperkalemia following ileostomy not colostomy. A 6△-year-old woman undergoing hemodialysis began developing severe hyperkalemia after ileostomy. Previous...