Hyperkalemia is a great imitator and can cause a variety of ECG changes. In severe hyperkalemia, the mean sensitivity is decreased to ~95%. In severe hyperkalemia, the mean sensitivity improves to ~30%. However, the ECG has a high specificity for detecting hyperkalemia and could be used as a rule in test 20. If the lab reports severe hyperkalemia but the ECG is normal, repeat the lab.Īn ECG is not a sensitive method of detecting hyperkalemia and should not be relied upon to rule it out.If the ECG shows features of hyperkalemia, this confirms the diagnosis. The first response to a lab report of hyperkalemia should be to obtain an ECG. This can be avoided by point-of-care testing or measuring labs in a heparinized tube. platelets > 1 million or WBC count > 50,000).
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