Skip to Main Content

+

  • • Elevated serum potassium

++

Epidemiology

+

  • • Severe trauma

    • Burns

    • Crush injuries

    • Renal insufficiency

    • Marked catabolism

    • Addison disease

++

Symptoms and Signs

+

  • • Nausea

    • Vomiting

    • Colicky abdominal pain

    • Diarrhea

++

Laboratory Findings

+

  • • Elevated serum potassium

    • Peaked T waves

    • Wide QRS

    • Depressed ST segment

+

  • • Addison disease

++

Rule Out

+

  • • Hemolysis

    • Leukocytosis

    • Thrombocytosis (> 1,000,000/µL

    • Abnormalities of acid-base status (acidosis)

    • Addison disease

+

  • • Serum electrolytes

    • CBC with platelets

+

  • • IV 100 mL D50 with 20 U regular insulin

    • IV NaHCO3

    • IV calcium

    • Sodium polystyrene sulfonate orally or by enema (40-80 g/d)

    • Hemodialysis

    • β-Agonists (inhaled)

++

Medications

+

  • • D50/insulin

    • Calcium

    • Sodium polystyrene sulfonate

    • NaHCO3

    • Albuterol

++

Treatment Monitoring

+

  • • Serum electrolytes

    • ECG

++

Complications

+

  • • Diastolic cardiac arrest

++

Prognosis

+

  • • Excellent

++

References

Greenberg A. Hyperkalemia: treatment options. Semin Nephrol. 1998;18:46.  [PubMed: 9459288]
Mahoney BA. et al. Emergency interventions for hyperkalaemia. Cochrane Database of Systematic Reviews. 2005, (2):CD003235.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.