HYPERKALEMIA UNLOCKED

DEFINITION
Serum pottasium level > 5.5 mmol/L

Severity Of Hyperkalemia
MILD

MODERAT
E
6 - 7

SEVERE

Flattening
of P waves
& QRS
widening
+

K level

<6

ECG
changes

Normal or
Peaked T
waves

Peaked T
waves

Interventio
n

+/-

>7

EFFECT OF POTASSIUM
Relaxation of excitable tissues..
Symptoms
Intestinal colic
Diaarhea
Muscle weakness

Treatment
1. Prevent the adverse effects of
Potassium
2. Send potassium into the cells
3. Send potassium out of the body
through GI and KIDNEY

Preventing the adverse

effects
Ultimately its our own
CALCIUM
DOES NOT change the potassium
levels.

Dose
Calcium gluconate - 1000mg in 2
3 min
Calcium chloride 500mg in 2 - 3
min
Can REPEAT after 5 min if ECG findings
are not reverted

Driving Potassium into the

cells
INSULIN +/GLUCOSE

BETA- 2
ADRENERGIC
AGONIST

SODIUM
BICARBONATE

Activates Na-k Activates Na-k Exchange with

pump
pump and NaH+ ions
k-2cl pump
10 units of PI
in 500ml of
10% dextrose
over 60 min

4 times the
dose used for
nebulisation

150 meq in 1 L
of 5%
dextrose

Driving potassium out of

cells
Cation exchange
Resins
Sodium polystyrene
sulfonate

Dialysis
hemodialysis

Now to find the cause of

Hyperkalemia
Medicine Cx

Till then we can think

EXECESSIVE
INTAKE

DECREASED
EXCRETION

SHIFT TO
EXTRACELLULAR
SPACE

HIGH K AND LOW

NA DIETS- sweet
potato, tomato
sauce, carrot, fish

RENAL FAILURE

HYPEROSMOLALITY

PENICILLIN G
THERAPY

DRUGS ACEI,
NSAIDS,
POTASSIUM
SPARING
DIURETICS,
HEPARIN

TISSUE BREAK
DOWN

PRBC
TRANSFUSION

PRIMARY ADRENAL
DISEASE - TB

PROPOFOL
SUCCINYLCHOLINE

THANK YOU