Another trip to the E.R. - Hypokalemia

Today, we received a call from Dr. Cohen. Doug had seen him yesterday and labs were taken. Dr Cohen called to say a few of Doug's labs were really, really low. Potassium was 2.2 and the Sodium level was 127. Normal potassium levels are 3.5 - 5.0 and normal sodium levels are 135 - 148 mEq/L. He stated this could be a life-threatening condition. Dr Cohen put in a call to Doug's primary care physician, Dr Strength...but never received a call back in a timely manner. Dr Cohen called us back and asked us to go to the nearest hospital for IV fluids with extra sodium and potassium. He said he would call the E.R. and fax them the lab results, so they would be prepared for Doug's arrival.

On admission to the E.R. an IV with sodium was run in over an hour, and oral potassium was given. Labs were re-drawn. The potassium was 2.4 in the E.R. and the sodium level was within normal limits..but now the phosphorus levels were noted as being high. Doug was given a potassium drink as well as another 1,000 ml saline drip with 40mEq of potassium added to run in over 2 hours. After this labs were redrawn and the potassium level was 3.4 - This was close enough to normal that he was discharged from the hospital.

The doctor did not know what caused his potassium/sodium/phosphorus levels to be low. He will add more potassium rich foods to his diet and monitor it with his primary care physician.

Hypokalemia is a condition of below normal levels of potassium in the blood serum. Potassium, a necessary electrolyte, facilitates nerve impulse conduction and the contraction of skeletal and smooth muscles, including the heart. It also facilitates cell membrane function and proper enzyme activity. Levels must be kept in a proper (homeostatic) balance for the maintenance of health. The normal concentration of potassium in the serum is in the range of 3.5-5.0 mM. Hypokalemia means serum or plasma levels of potassium ions that fall below 3.5 mM