Current hyperkalemia interventions co-administered with a dextrose 10% solution significantly lower hypoglycemic rates (CHICA-D10).

Background: Current protocols which include the administration of a single dextrose dose concomitantly with insulin are inadequate as hypoglycemia commonly occurs 60 min after insulin administration and may persist for up to two hours post-insulin administration. To prevent delayed hypoglycemic events, our institution revised our adult acute hyperkalemia order set to include hypoglycemic preventative measures not currently described in the literature.

Methods: The primary purpose of this retrospective study was to determine if the new adult acute hyperkalemia order set resulted in lower rates of hypoglycemia (glucose <70 mg/dL) compared to the old order set in patients with impaired renal clearance and lower pre-insulin glucose values.

Review of Subcutaneous Insulin Regimens in the Management of Diabetic Ketoacidosis in Adults and Pediatrics.

Objective: Summarize the studies evaluating the use of subcutaneous (SQ) insulin in the management of diabetic ketoacidosis (DKA) in adults and pediatrics.

Data Sources: A PubMed literature search was conducted for articles published between 2000 and the end of May 2024 which contained the following terms in their title: (1) subcutaneous, glargine, or basal and (2) ketoa*.

Study Selection And Data Extraction: Review articles, guidelines, meta-analysis, commentaries, studies not related to the acute management of DKA, studies evaluating continuous SQ insulin, animal studies, if the time to DKA resolution was not clearly defined, and studies where basal insulin was administered greater than 6 hours after the insulin infusion was started were excluded.

Emergency Medicine Physician Residents' Perceptions of Emergency Medicine Clinical Pharmacists' Involvement in Their Training.

Background: Although the clinical impact of emergency medicine clinical pharmacists (EMCPs) on patient care outcomes is well documented, their educational impact on resident physicians' training is not.

Objective: To further highlight the utility of EMCPs, this study evaluated emergency medicine (EM) resident physicians' perceptions of EMCPs' involvement in their training.

Methods: A voluntary, anonymous web-based survey was sent by email to all 44 EM resident physicians in July 2022.

High sodium, rather than high blood pressure, induces immune cell activation and renal infiltration in ovariectomized adult Wistar rats.

We used an animal model of salt-sensitive hypertension (SSH) in which ovariectomized (oVx) rats developed hypertension with high salt (HS) intake. Hypertension is accompanied by changes in the percentage of CD4 T lymphocytes, immune CD45 cell infiltration into renal tissue, and changes in Na, K- ATPase (NKA) expression in both renal tissue and peripheral blood mononuclear cells (PBMCs). To determine whether the observed changes resulted from HS intake, high blood pressure, or both, hydralazine (HDZ) was used to lower blood pressure.

Safety and Effectiveness of a Standardized Intravenous Insulin Infusion Order Set for Managing Uncontrolled Hyperglycemia Outside the Intensive Care Unit.

Background: Few studies have evaluated the administration of intravenous (IV) insulin infusions for uncontrolled hyperglycemia in non-intensive care unit (ICU) patients, and there is inadequate data to guide how to appropriately administer IV insulin infusions to this patient population.

Objective: Determine the effectiveness and safety of our institution's non-critical care IV insulin infusion order set.

Methods: This retrospective study was conducted at 2 institutions within a health care system.