On this quick episode I discuss hyperkalemia, a life-threatening condition commonly missed by out-of-hospital providers. It is essential to recognize the signs and symptoms of hyperkalemia as these patients may require prompt treatment to prevent fatal dysrhythmias.


    Durfey N, Lehnhof B, Bergeson A, et al. Severe Hyperkalemia: Can the Electrocardiogram Risk Stratify for Short-term Adverse Events?. West J Emerg Med. 2017;18(5):963–971. doi:10.5811/westjem.2017.6.33033
    Lehnhardt A, Kemper MJ. Pathogenesis, diagnosis and management of hyperkalemia. Pediatr Nephrol. 2011;26(3):377–384. doi:10.1007/s00467-010-1699-3
    Ryuge A, Nomura A, Shimizu H, Fujita Y. Warning: The ECG May Be Normal in Severe Hyperkalemia. Intern Med. 2017;56(16):2243–2244. doi:10.2169/internalmedicine.6895-15

(ECGs from Smith’s ECG Blog http://hqmeded-ecg.blogspot.com)

Subtle hyperkalemia indicated by peaked T-waves and ST segment flattening in V3-V5
Hyperkalemia indicated primarily by peaked T-waves in V2-V4
Wide QRS and significantly peaked T-waves indicating hyperkalemia
Substantially widened QRS with sine wave morphology indicating severe hyperkalemia

The Paramedic Practitioner © 2019