![]() ![]() He missed dialysis for the first time over the weekend to attend his niece’s wedding. Case SummaryĪ 52 year-old male with end-stage renal disease (requiring dialysis) is brought in by EMS feeling weak and dizzy. He missed dialysis on the weekend for the first time so that he could attend his niece’s wedding. He is diabetic and hypertensive and was started on hemodialysis 3 months ago for ESRD. He is not having chest pain, but has been feeling weak and dizzy today. Geoff is a 52 year old male who is brought to the ED by EMS as a STEMI activation. ![]() ACLS should be modified in hyperkalemia to include aggressive calcium chloride and bicarbonate administration in an attempt to correct the underlying cause of cardiac arrest.Recognizing hyperkalemia on ECG allows for the critical intervention of administering calcium gluconate.Hyperkalemia should be suspected as a possible cause of almost any symptom in a hemodialysis-dependent patient.This case highlights a few important points: However, placed out of context, the recognition of severe hyperkalemia on ECG can be quite challenging. When studied in isolation, the ECG findings of hyperkalemia can seem straight-forward. She is also one of the editors-in-chief here are EMSimCases. ![]() She is a PGY5 emergency medicine resident at McMaster University and has previously completed a fellowship in simulation and medical education. ![]()
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