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The House series has a patient with heart problems going down the same way from eating high K content Durian fruit, and I remember it because of a Passion fruit doing it to a CHF patient.., so the compounded effect of drugs is not so strange.
Many did not distrust a pandemic. Anyone with a bit of common sense opposed the falsehood and exaggerations of the Covid pandemic. People respond accordingly and proportionate to the facts.
Dr. Roger Schwell recalls a critical case involving a young patient in the ICU who experienced a rapid drop in heart rate due to hyperkalemia, a condition of elevated potassium levels in the blood. Noticing peak T-waves on the EKG monitor, Dr. Schwell suspected hyperkalemia exacerbated by succinylcholine, a paralytic drug given during intubation. The patient's potassium level was already high upon hospital admission. To quickly stabilize the patient, Dr. Schwell administered calcium chloride, which promptly improved the heart rhythm. He then employed additional strategies to manage the potassium levels, including medications and binders. This case underscores the importance of recognizing EKG changes and understanding the appropriate immediate treatments. Dr. Schwell also promotes MedCram's EKG course, emphasizing its practical and clinical value for medical professionals and enthusiasts.
That's a quick response. The typical course is a s you said that they isially keep going on for days with 100% high flow. Me neither, as an RT I discovered not see that on a patient. That's amazing! I had a lost of patients on chronic O2 Covid 19 patients.
Did the old lady also have low bp because of the low sodium? Could she have prevented the ER trip by replenishing her fluids with electrolytes? Given the price of electrolytes in the pharmacy, could she have done it with orange juice and a bit of salt?
I only took the first 2 doses no more after having Bell's palsy a few years after the shots mostly it was just occasional numbness or tingling on my left side and occasionally sharp stabbing pain in my chest area but resulting in normal heart conditions. Not myocarditis or heart attack.
Just being outside for 45 min you would have absorbed upwards of 20000 ius of D3, so the FDA are recommending too low of an amount. I don’t trust these Drs
My niece, 1st diagnosed with asthma as an adult, used her albuterol emergency inhaler too much & ended up in the hospital. Not sure of the details but perhaps the opposite of this patient's problem. PS i appreciate your teaching style.
I'm trying to understand why calcium administration would help hyperkalemia, I don't follow why it would stabilize the action potential. Seems to me the answer might be "Plasma levels of both norepinephrine and epinephrine and the metabolites normetanephrine and dihydroxyphenyl-glycol were significantly higher in the hypercalcemic group than in the other two groups" ie hypercalcemia raises adrenaline, which ramps up the sodium potassium pump. Snippet from Sympathetic system function and vascular reactivity in hypercalcemic patients, 1982 I guess if the doctor doesn't know that the peaked t wave means hyperkalemia the patient would be screwed. Btw Etomidate suppresses cortisol, which may be the source of the hyperkalemia.
Etomidate rarely causes hyperkalemia in my experience and it’s not listed as a side effect. Besides, aldosterone from the adrenal gland governs potassium far more than cortisol from the same.
Seems there should be more investigation in viroporins, and the effects on electrolyte homeostasis. Did anyone look at this during covid? The membrane transfer of viral and self, this fusion, ya, I think it can be detrimental especially in the heart!
I was suffering from chronic fatigue, brain fog, mild headache occasionally. Thought it was long covid. I went to a psychiatrist last year who diagnosed me with anxiety and depression
That was very interesting. I actually had the opposite problem a few years ago, I had a quad bypass and the put me on (amongst other things) a diuretic post op and within a few hours of waking up (I was lying in ICU) all of a sudden I had some 20 nurses and doctors surrounding me. They said I was in A-Fib and they gave me a shot of potassium. Apparently I'm a high K emitter when on Furosemide and so for the 3 months they were trying to get me to shed excess fluid I was taking a potassium supplement. I was told that my BP was 230/190 which post bypass surgery I'm guessing made me very lucky that the stitches held mere hours after they were put in.
I understand what your partner is saying but mine is different its watery (is that really a word). And ooh so salty. Maybe one day I'll find the answer its very strange. Nausea is slight but part of it and, when it stops I'm exhausted. Thank you for replying g I appreciate it. Pearl
This happened to me a little over 20 years ago. I had been through a massive trauma that broke many bones and caused extensive internal damage. Two weeks after I was put under for another procedure (using succ) and went into cardiac arrest. For over 30 minutes attempts were made for resuscitation which included cracking my chest and hand massaging / shocking my heart. What surprised many medical people and myself was that I had no heart or brain damage. The Chief of Anesthesiology visited me and explained in a manner similar to this vid. Thanks for the video.
@@TeddyRumble Heaven forfend. For all of the corporate/profiteer-driven hype, AI has very narrow use cases that mostly center around eliminating "grunt work" (situations that have easily-understood variables, but a LOT of them to go through). In a complex situation like this, I can guarantee an AI "decisionmaker" would have killed the patient by defaulting to the most common response(s).
Nurse with 10yrs experience. Great education. I guessed insulin glusose first follow by calcium gluconate. Mostly the trio given in ED before coming to the floor. Is there a difference between choices of chloride vs gluconate in this instance?
I am guess that you get chloride is the better choice because you get 2x + charges with chloride vs one with 1x with gluconate as well as chloride is just a salt that is probably more readily available to the body?
It’s whatever is on the crash cart. Getting it from pharmacy would take too long. Generally CaCl requires a central line and Ca gluconaye doesn’t but in this case I’d use which ever I could by hands on first.
Man… we need more doctors like you. You saved this man’s life. So taking to much albuterol can cause this or would it actually reduce your potassium? When I had Covid I was taking albuterol like crazy. I’m talking every 4 hours like clockwork because I just couldn’t breathe. My potassium came back slightly lower than normal but doctor wasn’t concerned.
Many years ago, I worked in a regional medical center, not a healthcare provider though. A new nurse was assigned to an ICU, which I don’t think was a great idea. She went to give a patient Lasix. The vial looked just like the potassium vial. She gave potassium. Instant cardiac arrest. This video plugs some holes in my mind based on that.
While much of this material is relevant, I don't see a specific video on hypokalemia. Perhaps some day? :) I ran into trouble a few weeks ago, and developed a ventricular arrhythmia that put me in the ER. Upon arrival, my K was 3.3, not stupidly low, but apparently low enough to produce serious effects. Despite deliberately eating a lot of high potassium food, I apparently ran my levels low with several consecutive days of modest sunset walking / (very light hiking) in the Arizona desert. I've done this for many year and never had an overt issue. Na was also a little below normal range. Thanks again for your videos!
If the patient had progressed to cardiac arrest, cardiac recovery would still have depended on restoring the correct charge gradient otherwise you're just in the same situation that brought on the arrest. In other words, if you hadn't correctly "guessed" hyperkalemia, the patient would have progressed to cardiac arrest and likely have died. Is that your take on this case? Just wondering as a lay person...
Yes. The importance of quickly identifying the cause of the peak t waves but also the understanding of knowing what the fastest intervention would be were the two keys in this case
Soon, the good doctor's knowledge will be at every practitioner's fingertips. A.I. will give even the most incompetent doctor the knowledge of the best doctor in the field. Count on it.
@@bobthrasher8226 that will not be the case. AI is used already to spot tumors in mammogram studies, and it is much more accurate than humans. AI is simply a tool.
