Physician's Assistant

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Letter (244 days ago 22:01)

Letter Tue 05 August 2025 22:01

Last Modified: 244 days ago

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Dear Colleague,

Re: Linda Mays, DOB: May 1945, 80-year-old lady

I received a call from the laboratory late in the evening of 5th August regarding some blood tests that you took from this lady in the morning.

I note from the GP record that she's currently being treated for infectious gastroenteritis with significant fluid losses and I also know her background of significant physiological frailty and that she lives in a nursing home. I was able to review the excellently completed treatment escalation plan which is also very helpful, so thank you for that.

Her potassium level came back as 2.3 with creatinine of 174 and neutrophilia. This is indicative of AKI 1.

I discussed with Claire, the lasting power of attorney and daughter, and we had a long frank discussion about the risks and benefits of hospital admission in order to resolve this hypokalaemia. She is now aware that this profound hypokalaemia can be very dangerous and lead to arrhythmia and death, but also that a hospital admission to correct this would likely be prolonged and lead to a decrease in quality of life for the patient.

After a long discussion we agreed that we would attempt to undertake treatment in the nursing home and not bring her to hospital.

I discussed with the nursing home who will try to deliver oral potassium replacement either with paramedics or from their own stores this evening, but I'd be grateful if you could follow up with her as soon as possible.

I tried to send you this message using QRx but unfortunately you don't use this service, so a letter is the only way I can get through to you.

Yours sincerely,
[Consultant name]

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