An 80 year old man sent in by Surgeon looking unwell post bowel resection for bowel obstruction.

Abnormal vital signs – low BP and tachycardiaInterpretation of blood results:

Severe life threatening hyperkalaemia requiring immediate action

Partially compensated metabolic acidosis

Normal anion gap

Renal failure

Hyponatraemia

Suggesting severe volume depletion

Look for precipitating factors including high output stoma, infection, general decline and debilitation following major surgery, post surgical complications, other renal tract abnormailities (eg. obstructive uropathy) etc.

Treatment Priorities:

Resuscitation

Treat hyperkalaemia (cardiac monitoring)

Look for precipitating cause