1. Resuscitation in special circumstances workshop Life-threatening electrolyte disorders
Version: Jun 2016

2. Learning outcomes At the end of this workshop you should be able to:
use a systematic approach to the assess and treat the patient with electrolyte disorders

3. What is your initial treatment? What investigations will you request?
Case study
Clinical setting and history
A 60-year-old man presents to the ED with a 2-day history of severe diarrhoea and vomiting. His medication includes frusemide and an ACE inhibitor.
Clinical course
ABCDE
A : clear
B : RR 20 min-1, SpO2 92% on room air, chest clear on auscultation
C : P 130 min-1, BP 80/50 mmHg, cool peripheries
D : responds to Voice
E : no rashes, looks pale
What is your initial treatment?
What investigations will you request? 3

4. Case study (continued)
Laboratory results:
Reference normal ranges
Na+
130 mmol L-1
mmol L1 K+
7.9 mmol L-1
mmol L1
urea
29.1 mmol L-1
mmol L-1
creatinine
841 μmol L-1
μmol L-1

5. Case study (continued)
Reference normal ranges
Na+
130 mmol L-1
mmol L1 K+
7.9 mmol L-1
mmol L1
urea
29.1 mmol L-1
mmol L-1
creatinine
841 μmol L-1
μmol L-1
Arterial blood gas results:
(patient on high-flow oxygen)
Reference normal ranges pH
7.11
PaO2
135 mmHg
> 75 mmHg on air
PaCO2
26 mmHg
35 – 45 mmHg
bicarbonate
9.0 mmol L-1
mmol L-1 K+
8.1 mmol L-1
mmol L-1
Na+
133 mmol L-1
mmol L-1
What is the diagnosis and what treatments will you start?

6. Case study (continued)
Clinical course
the patient is starting to look worse
a nurse brings you his 12-lead ECG 6

7. Case study - What does the 12-lead ECG show?

8. Case study Clinical course
the patient has a cardiac arrest with an initial rhythm of asystole
What is the management of cardiac arrest in hyperkalaemia? 8

9. Any questions?

10. Advanced Life Support Course Slide set
All rights reserved
© Australian Resuscitation Council (June 2016)