Severe Hypokalemia on EKG with Amal Mattu

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This mini-lecture with Dr. Amal Mattu from Essentials of EM is gold for diagnosing severe hypokalemia (usually less than 3) on EKG. We all know about U-waves, but these are non-specific for hypokalemia and generally not that helpful. But as the potassium drops significantly below normal levels, the T-waves begin to invert and the U-waves grow taller causing a “Reverse-Wellen’s” wave, or as he coined after his children, “NikEleKam Ts.” With this knowledge, you can give Magnesium before the labs result and prepare to replete the potassium much sooner.

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