Intensive Care Unit Physician, 1st Internal Medicine Department, University Hospital Plzeň, Plzeň, Czech Republic
Severe hyper- or hypo- kalemia belongs in the list of life threatening situations. This algorithm leads you through basics of recognition of severity of these electolyte disorders. Also it shows the following therapy applied in hospital and prehospital care. In case of hyperkalemia fast diagnosis of cardiac toxicity and right therapy is crucial. In case of hypokalemia the leading role takes agresive substitution. It is crucial to lead the substitution in agreement with rules that tell how to administer therapy in case we don't have secured central venous catheter.
Diabetic ketoacidosis (DKA) is one of the most common complications of diabetes mellitus and one of the most common reasons for acute emergency admission in diabetics. If left untreated, it has a high mortality rate. On the contrary, properly treated has an excellent prognosis. The presented algorithm clearly allows to understand not only the pathophysiology of DKA, but above all it summarizes the basic steps in treatment. It emphasizes the possible pitfalls of electrolyte imbalances and the importance of their timely and adequate solution.
Heat stroke from overheating of the body is often an underestimated danger for professional and hobby athletes. The uncontrolled rapid rise in body temperature during sports performance represents a medical urgency which requires an active approach even in pre-hospital care with the start of early active cooling with subsequent transport to the hospital facility. Untreated, it can lead to multiorgan failure syndrome and death. The presented algorithm describes the typical initial symptoms of overheating and heat stroke and very nicely summarizes the fundamental steps in prehospital and hospital care. It draws attention to the need for the organizers to be prepared for similar situations during mass sport events and raises the awareness of the professional public about this infrequent diagnosis.