A 45 year old woman is admitted with hyperosmolar hyperglycaemic non-ketotic coma (HONK). A routine ECG is performed.
- What does it show?
- What is your treatment of this problem?
- Flattening of P waves & peaked T waves consistent with hyperkalaemia.
- Treatment of hyperkalaemia:
- Intravenous calcium based on K levels
- Insulin/? Dextrose if she has HONK
- Resonium / beta 2 agonists
- Investigate for cause
- Renal function/electrolytes
The referenced article takes good care of the latter. The former is immediately recogniseable and requires little further discussion.
Again, I extend my thanks to LITFL for making public their awesome and massive ECG library.
Weisberg, Lawrence S. "Management of severe hyperkalemia." Critical care medicine 36.12 (2008): 3246-3251.