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Evening in the Emergency Department

I worked 10 hours today (6:30 am-4:30 pm), came home, went to Pizza Hut with Jackie and Kevin, and were home about 10 minutes and my sister called. She was short of breath, weak, and felt the same way as 2 weeks ago when her potassium was elevated.

Jackie and I picked her up and drove her to the Emergency Department.  She told me that her heart rate at home was in the 40’s; I had visions of having to pull over, drag her out of the car, and do CPR. As it was, we had a hard time getting her out of the car, as her legs were just not working.  But we did make it to the ED without any problems.

When we got to the ED,  she was taken back to a room fairly quickly, as her heart rate was 33. They took her back, did labs and an EKG, and found out not only that her potassium was at a potentially lethal level of 7.4 (normal is 3.5-5.0), but she was in heart block (the electrical system of her heart was not firing properly) from the elevated potassium.  For those with a medical background, specifically a 3:1 heart block, and I believe it was 2nd degree block.  They then took her to the “cardiac room”, put the external “pacer pads” on her (in case they need to do what is in effect an external pacemaker), and put her on a monitor. They then gave her IV insulin and D25 (glucose), along with sodium bicarb, and within about 20 minutes, her heart rate was going up into the 70’s. (insulin causes potassium to enter the cells, thus lowering the serum potassium level, which allows the muscles to once again work as they should).

The Nephrologist was in, ordered dialysis, and decided to admit her. The dialysis nurse then came in and started dialysis, and then she will go to a room in the hospital.

Jackie and I came home. since she was stable, and we both have to work in the morning. She’ll only be in until tomorrow. They want to do a “work up” to make sure the high potassium levels aren’t from something non-dietary. I’ll post again when I have more information.

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