Aggressive Hyperkalemia Treatment in the Prehospital Setting A Case Report

Main Article Content

Aaron M. Peth, BSEMS, NRP
Abraham Campos, MD

Abstract

This is a case of profound unstable hyperkalemia encountered in the American pre-hospital 911 setting, with subsequent aggressive treatment and stabilization. Although hyperkalemia may be present in the prehospital setting, it is difficult to diagnose without laboratory testing or a reliable history of illness. It is frequently encountered in the pre-hospital setting, especially in communities with high levels of comorbidities and multiple dialysis centers. However, in the spectrum of hyperkalemia presentations, many of these patients are either early in their disease presentation or found when already in cardiac arrest. Early identification and rapid, aggressive treatment are paramount to decreasing morbidity and mortality in these patient populations. This case shows how aggressive prehospital critical care can have a significant impact on patient outcomes.

Article Details

How to Cite
Peth, A., & Campos, A. (2024). Aggressive Hyperkalemia Treatment in the Prehospital Setting: A Case Report. International Journal of Paramedicine, (8). https://doi.org/10.56068/WNGE6809
Section
Case Reports
Author Biography

Aaron M. Peth, BSEMS, NRP, Creighton University College of Nursing

Department of Paramedicine, Clinical Instructor

References

Berend, K., de Vries, A. P. J., & Gans, R. O. B. (2014). Physiological approach to assessment of acid–base disturbances. New England Journal of Medicine, 371(15), 1434–1445. https://doi.org/10.1056/nejmra1003327

Choi, D. S., Shin, S. D., Ro, Y. S., & LEE, K. W. (2020). Relationship between serum potassium level and survival outcome in out-of-hospital cardiac arrest using captures database of Korea: Does hypokalemia have good neurological outcomes in out-of-hospital cardiac arrest? Advances in Clinical and Experimental Medicine, 29(6), 727–734. https://doi.org/10.17219/acem/122178

Grunau, B., Kime, N., Leroux, B., Rea, T., Van Belle, G., Menegazzi, J. J., Kudenchuk, P. J., Vaillancourt, C., Morrison, L. J., Elmer, J., Zive, D. M., Le, N. M., Austin, M., Richmond, N. J., Herren, H., & Christenson, J. (2020). Association of intra-arrest transport vs continued on-scene resuscitation with survival to hospital discharge among patients with out-of-hospital cardiac arrest. JAMA, 324(11), 1058. https://doi.org/10.1001/jama.2020.14185

Jung, B., Martinez, M., Claessens, Y.-E., Darmon, M., Klouche, K., Lautrette, A., Levraut, J., Maury, E., Oberlin, M., Terzi, N., Viglino, D., Yordanov, Y., Claret, P.-G., & Bigé, N. (2019). Diagnosis and management of metabolic acidosis: Guidelines from a French expert panel. Annals of Intensive Care, 9(1). https://doi.org/10.1186/s13613-019-0563-2

Kovesdy, C. P. (2016). Epidemiology of Hyperkalemia: An update. Kidney International Supplements, 6(1), 3–6. https://doi.org/10.1016/j.kisu.2016.01.002

Montford, J. R., & Linas, S. (2017). How dangerous is hyperkalemia? Journal of the American Society of Nephrology, 28(11), 3155–3165. https://doi.org/10.1681/asn.2016121344