Reduction of Total Body PotassiumĪny reversible underlying cause should be identified and appropriately managed*. Salbutamol nebulisers may also be additionally added in for further (albeit limited) reduction. These measures are only short term, as the potassium will leave the cells within 30-60 minutes, therefore repeated doses may be required. Variable rate insulin with dextrose infusion should be started (typically 200ml of 20% glucose with 10U of insulin over 30mins, yet varies with local policy), acting to increase cellular uptake of potassium and thus reduce serum concentration. ![]() Stabilisation of the MyocardiumĪ stat dose of intravenous Calcium Gluconate or Calcium Chloride (typically 10ml of 10%, dependent on local guidelines) should be started, either when ECG changes are present or in all cases of moderate or severe hyperkalaemiaĬontinuous cardiac monitoring is required following stabilisation treatment in such cases. Alert a senior to any complications developing. ![]() Whilst the rationale for the first and second management strategies may be self-evident, it is important to consider that the underlying cause for the hyperkalaemia must also be addressed.Įarly and repeated blood testing is vital and any ECG changes warrant urgent treatment and moving the patient to a high-dependency area. The management of a hyperkalaemic patient can be considered in three parts:
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