Sodium Potassium: The Dynamic Duo
Battefort et al. (2012) reviewed a case report in which a young nurse encountered a rare case of attempted suicide by intravenous potassium poisoning. The patient had administered themselves with 4 vials of 20 mL (10%) of potassium chloride causing the patient to suffer cardiac arrest. After initial resuscitation, the patient had 125mL of a 4. 2% intravenous solution of sodium bicarbonate injected allowing for their recovery. The patient went on to live with no lifelong effects of the incident. Sodium and potassium are both electrolytes in the body that help to aid with body functions for example blood pressure. This relationship between sodium and potassium levels in the body and how they interact is incredibly important to day to day life and between life or death.
Sodium is essential to all living things and is the principle cation in the bodies extracellular fluid. In humans, sodium is an essential nutrient mineral that regulates blood pressure. Our bodies are comprised of around 100 grams of sodium; however, we are constantly losing it in different ways. Therefore, we must replace it, for example, by consuming food that contain sodium naturally, such as milk and meat. In healthy individuals, nearly 100% of ingested sodium is absorbed during digestion and urinary excretion (Holbrook et al. , 1984). Extra sodium in the body can lead to high blood pressure. We only need on average 1-3g of extra sodium, however the average sodium intake humans ingest is closer to 10g (Wardener et al. , 2002). Decreased sodium levels can help control your blood pressure and lower your risk of cardiovascular diseases and strokes.
If the body has too little sodium an electrolyte abnormality known as hyponatremia occurs. It can cause life threatening symptoms that can be observed in different medical conditions such as liver disease (Hoorn & Zietse, 2013). Hyponatremia is studied and reported in both clinical and forensic literature as it can occur because of high endurance exercise but also in some unfortunate cases of child abuse where the child has succumbed to forced water intoxication. Up to 2007 there had been at least eight reported exercise hyponatremia related deaths (O'Brien et al. , 2001).
Potassium ions are essential electrolytes that are present in all of mammals' tissues and body fluids (Watanabe, Hasegawa & Suzuki, 2011). As sodium pumps water into the cell, potassium pumps the by-products of cellular processes out of the cell, eventually expelling these 'wastes' from the body. Low potassium levels raise blood pressure whereas high potassium lowers blood pressure. Increasing the consumption of fruit and vegetables in the diet increases potassium levels (Gerstenblith & Margolis, 2013).
Although drug reacted deaths are common, potassium poisoning is incredibly rare with only a few cases reported. This may be because it is hard to detect potassium poisoning due to the post-mortem biochemical investigat...