Ep 150 Acute Kidney Injury – A Simple Emergency Approach to AKI

Emergency Medicine Cases

Dr. Anton Helman

Science, Courses, Medicine, Health & Fitness, Education

4.7 • 602 Ratings

🗓️ 22 December 2020

⏱️ 78 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this first part of our 2 part podcast series on AKI we answer questions such as: Is there any value in the BUN:Cr ratio in distinguishing prerenal from intrarenal disease? Why is nephritic syndrome one of the most important intrarenal causes to pick up in the ED? Is there any value in urine electrolytes for the ED workup of AKI? Is there a role for bicarb in patients with severe AKI? How can we choose wisely when it comes to imaging for patients with AKI? How can we utilize POCUS best in working up the patient with AKI? What are the indications for ordering a CK to look for rhabdomyolysis? At what CK level do patients typically develop AKI? How can the McMahon score help us manage rhabdomyolysis? What is the value of urine myoglobin in the workup of rhabdomyolysis? What are indications for dialysis in patients with rhabdomyolysis? What are safe discharge criteria for patients with rhabdomyolysis? and many more...

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases podcast. I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC studios in Toronto.
0:13.8	EM cases is part of Shremi, the Schwartz-Riseman Emergency Medicine Institute. That's the nonprofit organization dedicated to improving EM care through high
0:21.4	quality research and education. The opinions expressed on this podcast are intended for general
0:24.8	information and educational purposes only and should not be used to diagnose treat or prevent any
0:27.3	medical condition, nor should they be used as a substitute for medical advice from a qualified
0:29.5	practicing physician. Unless stated otherwise, the opinions expressed by the hosts or guests are made in
0:32.0	their individual capacity, not on behalf of the Institute nor Medicine Cases.
0:36.9	Here at EM cases, we strive to bring you the best broad, balanced EM knowledge to improve your
0:43.1	practice.
0:44.3	Now, what I'm about to say may come to you as a surprise.
0:49.3	Recent evidence shows that there are, in fact, more types of A.K.I.
0:54.1	than just pre-renel.
0:56.0	Okay, I know what you're thinking. Anton, we don't listen to EM cases for salacious rumors and unproven opinions.
1:04.0	But hear me out, because apparently other specialties have been discussing nebulous concepts like a renal disease for years.
1:13.4	Which leads me to a couple of questions. How comfortable are we in the ED charting anything but
1:19.4	pre-renel A.K.I. Since when did the term multifactorial A.K.I. become synonymous with, I don't know
1:27.4	why the creatin ends up.
1:29.3	Turns out those brilliant, well-rested nephrologists have been onto something all along.
1:35.4	So today, we're going to unravel the mysteries of the elusive kidney without getting too much
1:40.9	into the weeds. I did not invite a nephrologist specifically for this reason.
1:47.2	Instead, we've got two special guests who manage sick Akii patients on almost a daily basis
1:53.1	and who both have an incredible knack for seeing the forest for the trees. Both from Sunnybrook
	...

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