I give monthly lectures to the residents at three hospitals. I bill the lectures as a comprehensive, year-long, fluid and electrolyte course. I have never established a fixed curriculum for the lectures, here is one take:
- Body water, IV fluids and diuretics
- Rapid interpretation of ABGs
- Acute Kidney Injury
- Osmoregulation and hyponatremia
- Anion Gap metabolic acidosis
- Metabolic alkalosis and hypokalemia
- Non-anion gap metabolic acidosis
- Calcium and phosphorous and metabolic bone disease
- Electrolyte emergencies
- Board review practice
The curriculum starts with the basic mechanics that interns need to function in the hospital. How to order IVs, and intelligently use diuretics. This includes a review of body fluid compartments so that it is not just practical pearls but is based on physiologic foundation.
Electrolyte emergencies is a lecture that is not entirely written and needs to be. It would be a practical handbook style lecture to walk interns and residents through what I think is the best way to handle: metabolic acidosis and alkalosis, hypo- and hypernatremia, hypo- and hyperkalemia, hypo- and hypermagnasemia, hypo- and hypercalcemia.
The introductory curriculum ends with the rapid interpretation of ABGs. After that I turn the intensity up a bit and focus on more physiologic based and less practical aspects of electrolytes. This allows deep dives on metabolic acidosis with separate lectures on anion and non-anion gap. I separate out metabolic alkalosis and potassium to provide time to do a deep dive on the monogenic causes of hypertension.
The board review session is a quiz session to review all the concepts of the year.
I have one spare month because a lecture always gets lost along the way.