Tasty Morsels of EM 015

I keep a little, ever-expanding note on my phone where I jot down little morsels of goodness that I pick up while listening to or reading one of the many excellent sites/podcasts in the useful resource section.

I’ll try and transfer them here for your enlightenment.

I can’t quite remember where I found the link, but I suspect it was from EMCrit.

Continuous infusion of a standard combination solution in the management of hyperkalemia Nephrol Dial Transplant (2011) 0: 1–6 PMID 21220753 

• Very basically this is a cocktail of all your hyperkalemia solutions in one pre-made syringe

• NB sodium acetate is metabolised to bicarb
• run at 2 mL/kg/h for the first hour and then 1 mL/kg/h until potassium stabilizes at a safe level.
• on a slightly more entertaining level they did a chart review of kids who got the cocktail and out of their 20 kids, 5 before treatment were found to be in VF when they got 12 lead ECGs on them. Someone should tell them not to be getting 12 leads on kids in VF, it looks bad, especially when you publish it…
• they had to get their pharmacy to make it up and they had to discard it after 30 hours. it would be nicer if it was just something you could store in the fridge for a week or two at a time