Why Do So Many of My Patients Have Low Potassium in the ER?
I’m still very curious after this many years in practice. I Google stuff all the time. A couple of times I have scratched my head about patients of mine with low potassium in the emergency room. I even had that myself in one of my very rare visits to that kind of place. I did not enjoy the flavor of my oral potassium replacement.
This abnormality turned up again the other day, and I finally stopped in my tracks and said to the patient, “I often see this happening when my patients go to the emergency room, but after a little while it normalizes most of the time. It has to be some sort of stress reaction. But we will check your level again just to make sure”.
When I Googled it, everything fell into place. All the stress hormones lower potassium. It’s not their major effect or reason to exist, but that’s how it works. I don’t know if it serves any bigger purpose. But we should definitely not assume that patients under stress with low potassium need lifelong replacement therapy.
Thank you. I have wondered about potassium supplements a lot. I used to do a lot of hospital and ED follow ups and tried to figure out how and when I could get them off potassium supplements, as I am always trying to reduce med lists if possible. I have tried Rubicon consults and gotten different responses. A few times I have reduced the dose or stopped it and checked a BMP a few weeks later and it was always in normal range. I have seen potassium hang around in other charts for years and if I finally tracked it down it was usually started in one random ED or hospital visit and never questioned again. Fascinating that it might have all had to do with the stress of what brought them into the ED in the first place.
Good to know, thank you!