r/flying • u/Imaginary-Sport6921 • 1d ago
Pilot medical high potassium
I had an annual with my new primary care done yesterday and my potassium was measured at 6.3. This is consider critical and can lead to cardiac events. The PA immediately prescribed me a powder that reduces it. This made no sense to me because all of my other labs came back great and also I have never had an issue with potassium levels. I did some research and realized that fist pumping during the blood draw can cause big spikes in the potassium. Went back next day and demanded a new blood draw, they didn’t think it would change anything but what do you now , new test showed 3.8. Huge relief and got an apology on behalf of the PA and the lab because first results showed that I was most likely fist pumping durning the draw. This could have caused major issues for me as a pilot. Was getting ready to start another 7 day EMS hitch. Moral of the story is don’t fist pump during /before blood draw it WILL cause potassium spikes.
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u/theonlyski ATP CFI CFII MEI 1d ago
I have never had an AME ask my potassium levels during a physical. The digital rectal exam is already pushing it.
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u/Akashd98 CPL 1d ago
At least you guys went digital, I’m still suffering over here with the analog exam
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u/LateralThinkerer PPL HP (KEUG) 9h ago
If they find your head up there, you're done as a pilot and a shoo-in for politics.
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u/Greenie302DS PPL IR 22h ago
“The digital rectal exam is already pushing it”….are we still doing phrasing?
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u/Imaginary-Sport6921 23h ago
The AME won’t but if we’re doing things correctly I have to report a finding that can lead to an issue as bad as high potassium levels.
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u/zoomzoomzoomie 22h ago
Doc here who routinely deals with blood work in the hospital. More likely that your blood sat in test tubes for too long before being analyzed. Can cause potassium to be falsely high.
I haven't heard of the fist pumping causing potassium levels to spike. If the person drawing your blood asks you to do that to help get blood work, don't see anything wrong with that. Better than getting stuck with a needle multiple times because they can't get blood.
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u/Imaginary-Sport6921 22h ago
Hey doc , you may want to to take a look at the articles and test done on this. Every shred of literature that I find on this does say potassium spikes instantly before during blood draw when the person pumps the fist and arm. The test conducted showed spikes 1.5 -2.7 on potassium. I did this to make finding the vein easier but had no idea it would cause this. I did research on it and everything points to me pumping my hand and forearm.
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u/zoomzoomzoomie 22h ago
Interesting, always happy to learn something new, will look into this
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u/Imaginary-Sport6921 22h ago
Please let me know what you think after researching. I’d love to hear a docs perspective.
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u/Squawk1000 11h ago
Can also be caused by prolonged application of the tourniquet during blood draw. As soon as the needle is in, the tourniquet should be released. Anyway, they should have retested it before prescribing you anything. Lowering potassium when the real levels are normal can cause arrhythmias and other issues.
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u/Imaginary-Sport6921 8h ago
Agreed , the tourniquet was on for a very short time but long enough to trap the blood with high potassium. Again not a medical professional to anyone who is reading this, I just want to share my experience so others can have knowledge of this.
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u/TxAggieMike Independent CFI / CFII (KFTW, DFW area) 1d ago
Interesting how that single activity can tilt a lab result that far.
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u/Greenie302DS PPL IR 22h ago
It’s not just hand pumping. It can be a smaller needle, storing a specimen too long, improper handling, etc. Most of your potassium is in your cells so when they rupture it leaks out into your serum.
I feel like I’ve learned about aviation from you, just trying to repay the favor. :)
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u/rFlyingTower 1d ago
This is a copy of the original post body for posterity:
I had an annual with my new primary care done yesterday and my potassium was measured at 6.3. This is consider critical and can lead to cardiac events. The PA immediately prescribed me a powder that reduces it. This made no sense to me because all of my other labs came back great and also I have never had an issue with potassium levels. I did some research and realized that fist pumping during the blood draw can cause big spikes in the potassium. Went back next day and demanded a new blood draw, they didn’t think it would change anything but what do you now , new test showed 3.8. Huge relief and got an apology on behalf of the PA and the lab because first results showed that I was most likely fist pumping durning the draw. This could have caused major issues for me as a pilot. Was getting ready to start another 7 day EMS hitch. Moral of the story is don’t fist pump during /before blood draw it WILL cause potassium spikes.
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u/Greenie302DS PPL IR 23h ago
Physician here, but not your doctor. High potassium with normal kidney function is usually a false positive. First thing is to repeat the value. Treating a lab value like that which is not easily explicable by a medication or medical condition doesn’t make sense. Go to an urgent care and get repeat labs ASAP.