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I was looking over a past case of hyperkalemia in the ED and was wondering how long it takes to get a patient to emergent dialysis. Can anybody share a story?
How long to activate dialysis lab
- Thread starter deuist
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Does the patient already have vascular access? If so, it takes about an hour in my hospital for them to call in the staff and set it up.
It takes longer if we have to put in a vascular cath and start having problems.
It takes longer if we have to put in a vascular cath and start having problems.
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Let's go with no vascular access. For a first-timer, how long does the lab take to get ready? Also, do you have a preferred method of temporarily treating the hyperkalemia (e.g., insulin vs albuterol)?
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Yes, insulin/D50, albuterol, kayexalate, furosemide, calcium gluconate, and sodium bicarbonate; calcium gluconate indicated if there are QRS changes.
It depends on which hospital I am at. At one hospital I can throw in a Quinten, but at another hospital I cannot. If I can do it, then the dialysis lab is up and running the same as with anyone with access. If I have to have interventional radiology to place it, then it's all time dependent on the IR guy who is on call, who has to activate his/her lab. That might take another 3-4 hours.
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Just had my first hyperK+ case at my new job, a community hospital. Right after I instituted the K+ treatment, the dialysis center at the hospital called ME to see if I was ready to send the patient up. Literally 60 seconds later the nephrologist asked if she could dialyize the patient right now. THis was in the afternoon.
Odd.
At my old job in DC, where it is the highest per capita ESRD ratio (due to noncompliant HTN/DM in the general population), where literally 10-20% of my patients were ESRD any given day, it would actually take LONGER to get dialysis set up, they would languish in the ED for 1-2 hours before the center would be ready.
That being said, those ESRD paitents were super hardy and strong. Even with no kidney function at all They would go 5-10 days without dialysis before they even had any symptoms. Weird.
Q
Odd.
At my old job in DC, where it is the highest per capita ESRD ratio (due to noncompliant HTN/DM in the general population), where literally 10-20% of my patients were ESRD any given day, it would actually take LONGER to get dialysis set up, they would languish in the ED for 1-2 hours before the center would be ready.
That being said, those ESRD paitents were super hardy and strong. Even with no kidney function at all They would go 5-10 days without dialysis before they even had any symptoms. Weird.
Q
