I've been a nurse 30 years and I listen to your lessons every day. I learn something beneficial every day and helps me give the best care I can. Thank you for sharing your knowledge! 8/28/23 11:30 a.m.
This is awesome. One of the reasons I love doing these videos so much is that they 1) help refresh things and 2) Im always learning something new along the way.
Important pottasium points: it’s a vesicant if hypokalemia is severe give it fast centeral line, if it’s moderate and they’re asymptomatic peripheral line slow choose a big vein it burns!, if they’re symptomatic arrhythmia tachycardia centeral line, if it’s low or mild prob give oral now if they’re having metabolic acidosis on top of low pottasium give them oral pottasium bicarbonate… also key point don’t push or bolus pottasium ever this isn’t a prison. watch out for patients who have oliguria, they will accumulate pottaisum in the body and youlle give them a deadly arrhythmia! Don’t give pottaisum to a hypokalemic who has olguria!
These videos are awesome. Thank you! New graduate that is out of orientation. Great just to listen to as a refresher or explains stuff that my preceptors didn't really have an answer to.
Awesome, glad you liked it man! I try to make these videos as resources for people because theres always so much to learn, and certainly things that often do get missed in orientation and schooling.
If you give a patient 40 mEqs of Kcl + 30ml of saline (50ml total) at a velocity of about 20ml/hour through syringe pump, how does this translate to actual serum Kcl increases? I read a study that said that increases are actually "low", we talk about 0.3 to 0.6 mEq serum increase with 40meq
As a paramedic I administer Ca Chloride via IV for hyperkalemia (w/ bicarb), acidosis, Calcium channel blocker overdoses, etc. So my question is why is a central line preferred for replacement therapy?
CaCl2 can be a vessicant. If calcium must be given via peripheral IV, calcium gluconate can be used, if only chloride is available, dilute it with saline. And always make sure to flush well or use a separate line for your bicarb
regarding the protocols you have showed us? you said it depends on the hospital where you are working. from where you are working? what book you might recommend as reference for the protocols? thank you.
Thank you for the amazing video, one question, when replacing potassium do you have to add the daily requirements of potassium to the amount of potassium that you're giving for the deficit?
Too much sodium; give fluids. Too little sodium; limit fluid intake. You don’t want to correct too fast in either directions. Risk of cerebral edema if it falls too quickly, and a risk of osmotic demyelination if it rises too quickly.
What about Natrium? It would have been usefull if you would have mentioned the formulas used for the correction of Potassium and Natrium in hyponatremia and hypokalemia. Great videos!
I had 3 weeks of diarhea from a supplement that was causing it. I was hit with a headache and stopped urinating for 8 hours. Now I suffer chronic electrolyte imbalance symptoms that I cannot fix. The doctor told me I'm crazy and it should have corrected with water consumption. I feel worse than trash.
Thanks for the video. Can you elaborate more on "IV Replacement can lead to complications & life threatening situations?" Did you just mean that replacing too quickly can lead to arrhythmias, supratherapeutic adverse effects, pain in IV sites, etc?
Feel so blessed finding your channel, thank you for the great content. My question is do you have a location where I could get this testing and protocol?
You should write everything important that you are saying, For ex at 2:28 you said "the lower the pH the higher the potassium" but you didn't write it down. 11:58 "If patient didn't respond to the replacement, check magnesium level" but you only write "check mg?" Consider it like a slide presentation, all info should be contained in the slide whenever possible.
Also remember to never crush PO replacements of potassium. Splitting the pill in half is okay but never crush potassium as it will release the entire drug at once thus increasing S/E.
disagree Giving potassium too fast is dangerous only when it is given via IV route. Enteral absorption of potassium is slow enough. So you are safe even if you eat a lot of powdered potassium at once. Powdered potassium tastes terribe, and this is the reason why potassium shouldn't be crushed.
Yes sorry! I am in the midst of preparing for a cross country move next month. I needed to slow down for a little bit but once I get settled in, I plan to get back to the 2 videos a week schedule!
I've been a nurse 30 years and I listen to your lessons every day. I learn something beneficial every day and helps me give the best care I can. Thank you for sharing your knowledge! 8/28/23 11:30 a.m.
This is awesome. One of the reasons I love doing these videos so much is that they 1) help refresh things and 2) Im always learning something new along the way.
First year PA student here- your videos are so helpful! I hope I have nurses like you on my ICU rotation!
Awesome! Really glad you are liking the videos! Best of luck in your training.
This is one of the greatest videos I’ve watched about electrolytes. Straight to the point! Thanks 🙏
Wow, thank you so much Carl!
Important pottasium points: it’s a vesicant if hypokalemia is severe give it fast centeral line, if it’s moderate and they’re asymptomatic peripheral line slow choose a big vein it burns!, if they’re symptomatic arrhythmia tachycardia centeral line, if it’s low or mild prob give oral now if they’re having metabolic acidosis on top of low pottasium give them oral pottasium bicarbonate… also key point don’t push or bolus pottasium ever this isn’t a prison. watch out for patients who have oliguria, they will accumulate pottaisum in the body and youlle give them a deadly arrhythmia! Don’t give pottaisum to a hypokalemic who has olguria!
These videos are awesome. Thank you! New graduate that is out of orientation. Great just to listen to as a refresher or explains stuff that my preceptors didn't really have an answer to.
Awesome, glad you liked it man! I try to make these videos as resources for people because theres always so much to learn, and certainly things that often do get missed in orientation and schooling.
Can you do a full explanation of electrolytes itself?
Yes, I'll add to the todo list
@@ICUAdvantage Also, you didn't talk about Sodium. Awesome video BTW.
If you give a patient 40 mEqs of Kcl + 30ml of saline (50ml total) at a velocity of about 20ml/hour through syringe pump, how does this translate to actual serum Kcl increases? I read a study that said that increases are actually "low", we talk about 0.3 to 0.6 mEq serum increase with 40meq
Tell me more about renal function being negatively effected by electrolyte replacement.
Thank you so much for this!!
You are very welcome Victoria!
@17:07 I'm wondering if he meant monitoring for if the BUN is >30 rather than
As a paramedic I administer Ca Chloride via IV for hyperkalemia (w/ bicarb), acidosis, Calcium channel blocker overdoses, etc. So my question is why is a central line preferred for replacement therapy?
CaCl2 can be a vessicant. If calcium must be given via peripheral IV, calcium gluconate can be used, if only chloride is available, dilute it with saline. And always make sure to flush well or use a separate line for your bicarb
Thank you great job
Thank you so much Ali!
What about sodium replacement in severe hyponatremia ?
Treatment depends on volume status
regarding the protocols you have showed us? you said it depends on the hospital where you are working. from where you are working? what book you might recommend as reference for the protocols? thank you.
are there still weekly prizes?
All of your videos are so helpful, to the point, and relevant to clinical practice. Thank You!!!
So great to hear this! Thank you!
Thanks for sharing your deep knowledge
Glad to be able to help!
Thank you for the amazing video, one question, when replacing potassium do you have to add the daily requirements of potassium to the amount of potassium that you're giving for the deficit?
We just replace based on the protocol which is based on their level from labs.
@@ICUAdvantage Thank you!
WHAT ABOUT SODIUM IMBALANCES?
THANKS FOR THE INFORMATIVE VIDEO.
We don't usually see that as a part of the electrolyte replacement protocols.
I did cover sodium in the fluids series. With sodium we are actually looking at water balance not true sodium levels.
Can we run electrolytes together when replacing them?
Quite okay but how come you leave sodium? One of the important electrolyte
Too much sodium; give fluids.
Too little sodium; limit fluid intake.
You don’t want to correct too fast in either directions. Risk of cerebral edema if it falls too quickly, and a risk of osmotic demyelination if it rises too quickly.
What medications cause the imbalance?
Thank you for your effort
My pleasure!
Thank you!
Can you make a video on X-ray topic also
Yes please
I can certainly add to the todo list. Anything in particular you are looking for?
@@ICUAdvantage Basics of Chest X-ray
What about Natrium? It would have been usefull if you would have mentioned the formulas used for the correction of Potassium and Natrium in hyponatremia and hypokalemia. Great videos!
the formula for correction of hyponatremia is- one order of mcdonalds fries per hour until levels increase to within limits.
Great topic , thank you
Glad you liked it!
@@ICUAdvantage yes we liked it!
Is the calcium gluconate given as infusion or iv push over 10 min
Thanks again for Such a good video
I love you for these videos
Haha thanks! Glad you like them!
My father died from fatal arrythmia in relation with electrolyte imbalance, what does it mean?
I had 3 weeks of diarhea from a supplement that was causing it. I was hit with a headache and stopped urinating for 8 hours. Now I suffer chronic electrolyte imbalance symptoms that I cannot fix. The doctor told me I'm crazy and it should have corrected with water consumption. I feel worse than trash.
Excellent Channel, thanks alot...
Glad you like it!
Thanks for the video. Can you elaborate more on "IV Replacement can lead to complications & life threatening situations?" Did you just mean that replacing too quickly can lead to arrhythmias, supratherapeutic adverse effects, pain in IV sites, etc?
Hey Kyle. I could have been more clear. That is exactly what I was referring to :)
Thanku
You’re welcome Rachana!
Very good topic
Thank you!
I love your content, new subscriber here. Was wondering if you could please do a video on a head to toe Critical Care Assessment?
Thanks Trevor. I do have that on the todo list to cover at some point in the future.
Wow! got to learn a lot from you
Awesome! Happy to hear this!
@@ICUAdvantage 👍🙏
Feel so blessed finding your channel, thank you for the great content. My question is do you have a location where I could get this testing and protocol?
Glad to have you Mercedez! Feel free to shoot me an email at icuadvantage@gmail.com
I have been taking about 1000mg magnesium per day for 3 months and i feel bad and dehyrated the whole time...can too much magnesium do this?
yes u only need about 400-500
You should write everything important that you are saying,
For ex at 2:28 you said "the lower the pH the higher the potassium" but you didn't write it down.
11:58 "If patient didn't respond to the replacement, check magnesium level" but you only write "check mg?"
Consider it like a slide presentation, all info should be contained in the slide whenever possible.
Appreciate the feedback
What about sodium
We don't have that on an electrolyte replacement protocol
HELLO INTERNS
Ue fratm o cine
Congrats!
Did you mean BUN > 30?
Sure did! *facepalm*
Also remember to never crush PO replacements of potassium. Splitting the pill in half is okay but never crush potassium as it will release the entire drug at once thus increasing S/E.
disagree
Giving potassium too fast is dangerous only when it is given via IV route.
Enteral absorption of potassium is slow enough.
So you are safe even if you eat a lot of powdered potassium at once.
Powdered potassium tastes terribe, and this is the reason why potassium shouldn't be crushed.
Why they make that K+ so BIG?!
You haven't been making new videos as frequently as you were :(
Yes sorry! I am in the midst of preparing for a cross country move next month. I needed to slow down for a little bit but once I get settled in, I plan to get back to the 2 videos a week schedule!
My husband almost died because the dr gave him the wrong blood pressure medicine. His heart rate was 40bpm.