BRASH Syndrome
B - Bradycardia
R - Renal failure
A - AV nodal blockade
S - Shock
H - Hyperkalemia
Typical ECG in BRASH: HR 30, peaked T waves, flattening of P waves (Bradycardia out of proportion to other findings of hyperkalemia)
BRASH Treatment:
• Aggressive treatment of hyperkalemia
• Consider epinephrine (↑HR and drives K+ intracellularly)
• If hypovolemic, give IV fluids ("balanced fluids" > normal saline)
• If on a Ca2+ channel blocker, ß blocker, or digoxin, consider reversal strategy
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