Description
Answers 1
1. This ecg shows a broad complex rhythm with loss of p waves (small p wave in I only) and a QRS complex broadening into the T wave. Such changes are typical of hyperkalaemia. The usual progression is from tented T waves and broadening of the QRS proceeding into the T wave. This man’s potassium was 8.1 mmol/l. A potassium greater than 6.5 mmol/l or ECG changes in hyperkalaemia demand emergency treatment to lower serum potassium.
2. This man is hypotensive, anuric and hyperkalaemic following a crush injury. He is likely to have Rhabdomyolysis. This can be confirmed with elevated serum creatine phosphokinase, lactate dehydrogenase and transaminases. Myoglobin will also be present in urine. He will be severely dehydrated, which contributes to the renal failure associated with rhabdomyolysis.
