Authors:  Lou Mitchell, Steve Fordham / Editor: Clifford J Mann / Reviewer: Joe Schrieber / Codes: A1, A4, A5, O7Published: 07/01/2020

A 60-year-old man presented to the Emergency Department (ED) with a 1 week history of increasing lethargy, intermittent tingling in both arms and palpitations. He had a history of paroxysmal atrial fibrillation and hypertension. Medication history was of regular aspirin, metoprolol, digoxin, iron supplementation and paracetamol as required.

Examination revealed stable ABC findings with GCS 15 and no focal neurological deficit. Blood Glucose was 6 and he was apyrexial.

While sending venous bloods the triage nurse did a venous gas showing a potassium of 6.6.

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