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Emergency Treatment of Hyperkalaemia: Protect The Heart

This document provides guidance on the emergency treatment of hyperkalaemia (high potassium levels). It recommends assessing the patient using the ABCDE approach and monitoring the ECG if potassium is ≥6.5 mmol/L. Treatment is guided by the severity of hyperkalaemia and any ECG changes, and may include IV calcium, insulin with glucose infusion, nebulized salbutamol, oral potassium binders, or dialysis for severe cases. Monitoring of potassium and blood glucose levels is important during treatment to prevent complications.

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dilie1992
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502 views1 page

Emergency Treatment of Hyperkalaemia: Protect The Heart

This document provides guidance on the emergency treatment of hyperkalaemia (high potassium levels). It recommends assessing the patient using the ABCDE approach and monitoring the ECG if potassium is ≥6.5 mmol/L. Treatment is guided by the severity of hyperkalaemia and any ECG changes, and may include IV calcium, insulin with glucose infusion, nebulized salbutamol, oral potassium binders, or dialysis for severe cases. Monitoring of potassium and blood glucose levels is important during treatment to prevent complications.

Uploaded by

dilie1992
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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EMERGENCY TREATMENT

OF HYPERKALAEMIA
• Assess using ABCDE approach
• 12-lead ECG and monitor cardiac rhythm if serum potassium (K+) ≥ 6.5 mmol/L
• Exclude pseudohyperkalaemia
• Give empirical treatment for arrhythmia if hyperkalaemia suspected

Mild Moderate Severe


K 5.5 - 5.9 mmol/L
+ K+ 6.0 - 6.4 mmol/L K+ ≥ 6.5 mmol/L
Consider cause and need Treatment guided by clinical Emergency treatment
for treatment condition, ECG and rate of rise indicated

Seek expert help

ECG Changes?
Peaked T waves Broad QRS Bradycardia
Flat/ absent P waves Sine wave VT

NO YES

IV Calcium
10ml 10% Calcium Chloride IV OR
Protect the 30ml 10% Calcium Gluconate IV
heart • Use large IV access and give over 5 min
• Repeat ECG
• Consider further dose after 5 min if ECG changes persist

Insulin–Glucose IV Infusion
Glucose 25g with 10 units soluble insulin over 15 - 30 min IV
(25g = 50ml 50% glucose; 125ml 20% glucose, 250ml 10% glucose)
If pre-treatment BG < 7.0 mmol/L:
Shift K+ Start 10% glucose infusion at 50ml/ hour for 5 hours (25g)
into cells
Risk of
Consider
hypoglycaemia

Salbutamol 10 – 20 mg nebulised
Consider Life-threatening
hyperkalaemia

*Sodium zirconium cyclosilicate *Sodium zirconium cyclosilicate


10g X3/day oral for 72 HRS OR 10g X3/day oral for 72 HRS OR
Remove K+ *Patiromer *Patiromer
from body 8.4G /day oral OR 8.4G /day oral
*Calcium resonium
15g X3/day oral
Consider Dialysis
*Follow local practice
Seek expert help

Monitor K+
and blood Monitor serum K+ and blood glucose
glucose K+ ≥ 6.5 mmol/L
despite medical
therapy

Prevention Consider cause of hyperkalaemia and prevent recurrence

Emergency treatment of hyperkalaemia. ECG – electrocardiogram; VT ventricular tachycardia. BG Blood Glucose

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