ABSTRACT
Hypokalemia and hyperkalemia are the most common electrolyte disorders managed in the emergency department. The diagnosis of these potentially life-threatening disorders is challenging due to the often vague symptomatology a patient may express, and treatment options may be based upon very little data due to the time it may take for laboratory values to return. This review examines the most current evidence with regard to the pathophysiology, diagnosis, and management of potassium disorders. In this review, classic paradigms, such as the use of sodium polystyrene and the routine measurement of serum magnesium, are tested, and an algorithm for the treatment of potassium disorders is discussed.
Subject(s)
Disease Management , Emergency Service, Hospital , Evidence-Based Medicine , Hyperkalemia/diagnosis , Hyperkalemia/therapy , Hypokalemia/diagnosis , Hypokalemia/therapy , Acid-Base Imbalance/diagnosis , Acid-Base Imbalance/physiopathology , Acid-Base Imbalance/therapy , Algorithms , Diagnosis, Differential , Electrocardiography , Humans , Hyperkalemia/physiopathology , Hypokalemia/physiopathology , Water-Electrolyte Imbalance/diagnosis , Water-Electrolyte Imbalance/physiopathology , Water-Electrolyte Imbalance/therapyABSTRACT
Hypokalemia and hyperkalemia are the most common electrolyte disorders managed in the emergency department. The diagnosis of these potentially life-threatening disorders is challenging due to the often vague symptomatology a patient may express, and treatment options may be based upon very little data due to the time it may take for laboratory values to return. This review examines the most current evidence with regard to the pathophysiology, diagnosis, and management of potassium disorders. In this review, classic paradigms, such as the use of sodium polystyrene and the routine measurement of serum magnesium, are tested, and an algorithm for the treatment of potassium disorders is discussed. [Points & Pearls is a digest of Emergency Medicine Practice].
Subject(s)
Emergency Service, Hospital , Evidence-Based Medicine , Hyperkalemia , Hypokalemia , Acid-Base Imbalance/diagnosis , Acid-Base Imbalance/physiopathology , Acid-Base Imbalance/therapy , Cation Exchange Resins/therapeutic use , Disease Management , Hematologic Tests/methods , Humans , Hyperkalemia/diagnosis , Hyperkalemia/physiopathology , Hyperkalemia/therapy , Hypokalemia/diagnosis , Hypokalemia/physiopathology , Hypokalemia/therapy , Magnesium/blood , Water-Electrolyte Imbalance/diagnosis , Water-Electrolyte Imbalance/physiopathology , Water-Electrolyte Imbalance/therapyABSTRACT
The 2014 Academic Emergency Medicine consensus conference has taken the first step in identifying gender-specific care as an area of importance to both emergency medicine (EM) and research. To improve patient care, we need to address educational gaps in this area concurrent with research gaps. In this article, the authors highlight the need for sex- and gender-specific education in EM and propose guidelines for medical student, resident, and faculty education. Specific examples of incorporating this content into grand rounds, simulation, bedside teaching, and journal club sessions are reviewed. Future challenges and strategies to fill the gaps in the current education model are also described.
Subject(s)
Emergency Medicine/education , Research/education , Sex Characteristics , Communication , Computer Simulation , Consensus , Female , Gender Identity , Humans , Male , Manikins , Patient Simulation , Quality of Health Care , Sex FactorsABSTRACT
Diagnostic imaging is a cornerstone of patient evaluation in the acute care setting, but little effort has been devoted to understanding the appropriate influence of sex and gender on imaging choices. This article provides background on this issue and a description of the working group and consensus findings reached during the diagnostic imaging breakout session at the 2014 Academic Emergency Medicine consensus conference "Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." Our goal was to determine research priorities for how sex and gender may (or should) affect imaging choices in the acute care setting. Prior to the conference, the working group identified five areas for discussion regarding the research agenda in sex- and gender-based imaging using literature review and expert consensus. The nominal group technique was used to identify areas for discussion for common presenting complaints to the emergency department where ionizing radiation is often used for diagnosis: suspected pulmonary embolism, suspected kidney stone, lower abdominal pain with a concern for appendicitis, and chest pain concerning for coronary artery disease. The role of sex- and gender-based shared decision-making in diagnostic imaging decisions is also raised.