AKI TCD Flashcards
ECG changes with Hyperkalaemia
No P waves but regular rhythm
Wide QRS complex
Peaked T waves
Treatment for severe hyperkalaemia
intravenous calcium gluconate and start a insulin/dextrose infusion
What drugs to stop in AKI
ACE/ARB
Diuretics
Anti-hypertensives
Metformin
Three phases of ATN
Oligouric phase, maintenance phase, polyuric recovery phase
Blood tests when septic
blood gas including glucose and lactate measurement blood culture full blood count C-reactive protein urea and electrolytes a clotting screen
immediate treatment for sepsis
Give a broad-spectrum antibiotic at the maximum recommended dose without delay (within 1 hour of identifying that they meet any high risk criteria in an acute hospital setting)
- Intravenous fluid bolus without delay (within 1 hour of identifying that they meet any high risk criteria in an acute hospital setting).
f this patient’s lactate level is > ? mmol/l, she is a very high risk of circulatory collapse and cardiac arrest, so need to be referred to ITU for consideration of invasive circulatory support (inotropes).
4
What fluid to give low BP sepsis?
immediate fluid resuscitation so should have 500 ml bolus of crystalloid fluid and reassessment of blood pressure immediately after. She can have up to 2 litres of fluid as boluses to see if BP responds before referring to ICU for invasive circulatory support.
AKI is a a rise in serum creatinine of … micromol/l or greater within … hours
26, 48
AKI is a … or greater rise in serum creatinine known or presumed to have occurred within the past … days
50%, 7
Six reasons for immediate referral for renal replacement
hyperkalaemia metabolic acidosis symptoms or complications of uraemia (for example, pericarditis or encephalopathy) fluid overload pulmonary oedema.
Assess people with any suspected infection to identify
possible source of infection
factors that increase risk of sepsis
any indications of clinical concern, such as new onset abnormalities of behaviour, circulation or respiration.
Suspect …… sepsis in patients having anticancer treatment who become unwell.
neutropenic sepsis
Antibiotics if meningococcal disease is specifically suspected
benzyl penicillin
Six things to test in blood in sepsis
blood gas, including glucose and lactate measurement blood culture full blood count C-reactive protein urea and electrolytes creatinine
