BRASH syndrome is more than the sum of its parts. In this episode, we unpack this complex clinical entity defined by bradycardia, renal failure, AV node blocker use, shock, and hyperkalemia...and explore how these factors create a dangerous, self-perpetuating cycle. You’ll learn how to distinguish BRASH from isolated hyperkalemia or AV blocker toxicity, understand the synergistic physiology behind its rapid progression, and discover a multimodal treatment approach that targets every component at once. From volume management to bradycardia support and electrolyte correction, we’ll walk through practical strategies to break the cycle and improve patient outcomes. Whether you’re in emergency medicine, critical care, or just curious about complex pathophysiology, this episode delivers the knowledge you need to act fast and think comprehensively.