It is one of the most uncommon causes of arrest, with cardiac output decreasing as the body attempts to preserve the core organs. Hypothermia occurs when the body’s core temperature drops below 30 C (86 F). The recommended treatment is a controlled but rapid infusion of potassium to normal levels.Ĭhoosing to do so intravenously has risks, particularly for patients that are hypomagnesemic in addition to their hypokalemia, and one should never administer undiluted IV potassium. Treatment of hypokalemia depends on the severity and the presence of symptoms and ECG abnormalities. Excessive vomiting/diarrhea or diuretic usage.The generally accepted range for hypokalemia is a serum potassium level of less than 3.5 mmol-1, with severe hypokalemia occurring when potassium levels fall below 2.5 mmol-1. In addition, you may observe a widening QRS complex. The first sign of hypokalemia is typically flattened T-waves, as well as prominent U-waves. It directly increases the likelihood of arrhythmias and sudden death. Hypokalemia is the most common type of electrolyte-related cause of cardiac arrest. Administering sodium bicarbonate or calcium chloride.Dialysis (for those suffering from kidney disease).It can also be treated in a variety of ways, including: Drugs (ACE inhibitors, angiotensin II receptor antagonists (ARB), diuretics, beta-blockers, and non-steroidal anti-inflammatory drugs).Beyond that level, the risk of cardiac arrest increases. There is no specific limit that defines hyperkalemia, but 5.5 mmol-1 is often referenced. It is commonly caused by impaired kidney functioning or excessive potassium release from cells. In addition, you may observe a widening QRS-wave. The first sign of hyperkalemia is typically taller & peaked T-waves. As such, it is crucial to the functioning of the heart, and either high levels (hyperkalemia) or low levels (hypokalemia) of potassium greatly increase the risk of cardiac arrest. Potassium is one of the key electrolytes that allows the body to contract muscles and conduct electrical signals through nerves. If the patient is suffering from metabolic acidosis, that can typically be resolved by administering sodium bicarbonate. If you determine they’re suffering from respiratory acidosis, that can be remedied by providing adequate ventilation. You can determine whether a patient is experiencing acidosis by performing an arterial blood gas evaluation. It can be either metabolic or respiratory, either of which can lead to cardiac arrest. Hydrogen Ion (Acidosis)Įxcessive hydrogen ions in the blood, otherwise known as respiratory acidosis, impairs the circulatory system, reducing oxygen uptake in the lungs. If needed, connect an oxygen source to supplement their normal respiration. If you observe your patient suffering from hypoxia, first ensure their airway is clear and their breathing is normal. This consideration can be a significant contributor to cardiac arrest. Respiratory depression, respiratory distress, slowing heart rate, or a pulse oximeter reading below 94% may indicate your patient is suffering from hypoxia. Hypoxia is a condition in which the body or a region of the body is deprived of adequate oxygen supply. Infusion of either standard saline or Ringer’s lactate should help to correct the issue. You may notice rapid heart rate and a narrow QRS wave on EKG, or significant blood loss, which would indicate hypovolemia may be a contributing factor. It can be a significant contributing factor to cardiac arrest. Hypovolemia is the decrease in the volume of blood in your body, which can be due to blood loss or loss of body fluids. In total there are twelve reversible conditions that make up the H’s & T’s: Hypovolemia These factors are primarily associated with PEA, but having a working knowledge of each will help you to diagnose the underlying cause of any ACLS-associated arrhythmia.
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