Acute Renal Failure With Volume Overload [Pulmonary Edema] In A Small Hospital With No Dialysis Capability – What Can You Do

In this post I review Best Case Ever 59 Management of Acute Renal Failure with Volume Overload, editing by Dr. Anton Helman, June 2017, from Emergency Medicine Cases.

I’ve placed this post with  a different from usual title, “Acute Renal Failure With Volume Overload In A Small Hospital With No Dialysis Capability – What Can You Do” so that I can more easily find it using my blog’s search function and/or category function.

Here is Dr. Helman’s introduction to the podcast and show notes:

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…

This podcast is so excellent that I’ve gotten a complete transcript from This is not an affiliate link. This is the first time I have used them and it is $ .90 a minute and will take 5 days at that price. I’ll post the transcript as private as I don’t have permission from Emergency Medicine Cases to post it.

Here are the show notes with some additions I’ve made [additions coming soon].

Four considerations in management of acute renal failure with volume overload




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


This entry was posted in BCE (Best Case Ever), Best Case Ever From EMC, Emergency Medicine Cases, Nephrology. Bookmark the permalink.