Sometimes our renal failure patients present short of breath with volume overload and we don’t have immediate access to dialysis. What then? Dr. Mike Betzner, EM doc and medical director of STARS air ambulance service and collaborator on EM Cases CritCases blog tells his Best Case Ever and his approach to this challenging clinical situation. He offers two commonly used solutions: nitroglycerin and BiPAP as well as two not so common solutions: phlebotomy and rotating BP cuffs blown to above SBP…

 

Podcast  production, sound design and editing by Anton Helman, June 2017

Four considerations in management of acute renal failure with volume overload

Nitroglycerin

BIPAP

Phlebotomy

Rotating BP cuffs q20-30mins blown to above systolic (with ketamine or fentanyl for pain control)

 

Drs. Helman and Betzner have no conflicts of interest to declare