> EtCO2 can be useful, as you can call an arrest if the patient
> isn't making any. I also find it very useful to
> measure the potassium as soon as possible. There was an
> excellent paper a few years ago that allowed
> rescuers to differentiate those who would survive in a mass
> casualty situation after an avalanche by a
> potassium estimation - all those with a potassium above the
> normal range died. I call arrests with a high
> potassium too. I know ALS says you should treat it.
>
Climate change, eh. When I was in Brighton we didn't have a single avalanche
all the time I was there.
I don't think you can extrapolate from this to our cardiac arrests. My
understanding of the pathophysiology. A previously fit and healthy patient
found without an output an unknown period after cessation of circulation
with a high potassium probably has a high potassium because of cell lysis
i.e. they've been dead for a while and at the very least have capillary
sludging. In these circumstances, a high potassium is an indication of how
long the patient has been dead. A situation where you know the down time and
hyperkalaemia may be a cause rather than a result of the arrest is very
different.
Personally if the patient hasn't achieved ROSC by the time I get the
potassium back, I call the arrest.
Matt Dunn
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