Hyperkalaemia - Emergency Treatment

 

Indications  Contraindications
  1. CaCl 10% 10ml (= 13meq/L)
    OR
    Calcium gluconate 10% 10ml (= 4.6meq/L)

 

ECG
  • QRS widening
  • 'Sine wave'

(not for peaked T waves)

 

Digoxin toxicity
  1. Salbutamol 25mg neb
  1. NaHCO3 8.4% 1ml/kg over 30 min

 

Associated metabolic acidosis Pulmonary oedema
  1. Insulin 5 Units IV stat
    Dextrose 50% 50ml IV stat

 

  1. Resonium 30g 4/24 (1g binds 1meq K+)

 

  1. Frusemide 40mg IV stat
When adequate hydrated
  1. Dialysis
Anuric/Renal failure