Episode 991: BRASH

Episode 991: BRASH

Contributor: Aaron Lessen, MD

Educational Pearls

BRASH Syndrome:

  • Bradycardia

  • Renal Failure

  • AV Nodal Blockade

  • Shock

  • Hyperkalemia

Clinical Features:

  • Profound bradycardia and shock in patients on AV nodal blockers:

    • Commonly, Beta Blockers or Calcium Channel Blockers

Etiology:

  • Caused by an inciting kidney injury:

    • Common triggers include precipitating illness, dehydration, or medications

    • Results in hyperkalemia

  • The enhanced effect of the combination of AV nodal blockade and hyperkalemia leads to a more profound presentation of shock.

Treatment:

  • IV Fluids, unless volume overloaded

  • Epinephrine for bradycardia

  • Lasix for volume overload, only if the patient is still making urine

  • Low threshold to dialyze for hyperkalemia
  • Focus on treating early and more aggressively.

References:

Farkas JD, Long B, Koyfman A, Menson K. BRASH Syndrome: Bradycardia, Renal Failure, AV Blockade, Shock, and Hyperkalemia. J Emerg Med. 2020 Aug;59(2):216-223. doi: 10.1016/j.jemermed.2020.05.001. Epub 2020 Jun 18. PMID: 32565167.

Summarized by Ashley Lyons OMS3

Editting by Ashley Lyons OMS3 and Jeffrey Olson MS4

Donate: https://emergencymedicalminute.org/donate/


Join our mailing list: http://eepurl.com/c9ouHf

Tämä jakso on lisätty Podme-palveluun avoimen RSS-syötteen kautta eikä se ole Podmen omaa tuotantoa. Siksi jakso saattaa sisältää mainontaa.

Jaksot(1178)

Podcast 1023: Torsades de pointes

Podcast 1023: Torsades de pointes

Contributor: Aaron Lessen, MD Educational Pearls: Case review of a patient with recurrent episodes of syncope and shortness of breath, during which she is found to have intermittent runs of polymorp...

28 Syys 5min

Podcast 1022: Emergent Dialysis

Podcast 1022: Emergent Dialysis

Contributor: Taylor Lynch, MD Educational Pearls: When a patient who missed dialysis presents to the emergency department, our clinical concern is who needs to be admitted to the hospital for emerge...

21 Syys 4min

Podcast 1021: Pulmonary Edema From Naloxone Administration

Podcast 1021: Pulmonary Edema From Naloxone Administration

Contributor: Travis Barlock, MD Educational Pearls: What is pulmonary edema?  Pulmonary edema is the accumulation of fluid initially in the interstitium of the lungs, that when severe enough can als...

14 Syys 4min

Podcast 1020: Benign Paroxysmal Positional Vertigo (BPPV)

Podcast 1020: Benign Paroxysmal Positional Vertigo (BPPV)

Contributor: Alec Coston, MD Educational Pearls: Benign Paroxysmal Positional Vertigo (BPPV) Common inner ear condition that can cause dizziness Diagnosis of BPPV can help to avoid admissions and ...

7 Syys 6min

Podcast 1019: Trauma Blunt Cardiovascular Injuries (BCVI)

Podcast 1019: Trauma Blunt Cardiovascular Injuries (BCVI)

Contributor: Aaron Lessen, MD Educational Pearls:  Blunt cerebrovascular injury (BCVI) BCVI is a traumatic injury to the carotid or vertebral arteries Patients may initially have no neurologic sy...

31 Elo 3min

Podcast 1018: Occult Ventricular Fibrillation on Echocardiography

Podcast 1018: Occult Ventricular Fibrillation on Echocardiography

Contributor: Aaron Lessen, MD Educational Pearls: Big question in cardiac arrest: is the rhythm shockable? Shockable: ventricular fibrillation (VF) and pulseless ventricular tachycardia Non-sho...

24 Elo 2min

Podcast 1017: CPR Hand Placement

Podcast 1017: CPR Hand Placement

Contributor: Taylor Lynch, MD Educational Pearls:  CPR is an important life-saving measure designed for anyone to perform. Chest compressions works by two mechanisms:  Cardiac pump: Direct squ...

17 Elo 2min

Podcast 1016: Hypokalemia

Podcast 1016: Hypokalemia

Contributor: Meghan Hurley, MD Educational Pearls: What is hypokalemia? Hypokalemia is when the measured blood level of potassium falls below 3.5 mEq/L (normal 3.5 - 5.2 mEq/L).  Can generally be ...

10 Elo 6min

Suosittua kategoriassa Tiede

rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-hereilla
tiedekulma-podcast
utelias-mieli
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-tiedetta-vai-tarinaa
docemilia
rss-duodecim-lehti
rss-bios-podcast
university-of-eastern-finland
hippokrateen-vastaanotolla
rss-radplus
radio-antro
rss-ranskaa-raakana