Hyperkalemia

Hyperkalemia = EKG… EKG changes = Calcium… Step 1: Recheck the Potassium * Most common cause of hyperkalemia is PSEUDOhyperkalemia* Caused by too aggressive/fast of a blood draw* Causes RBCs to break open and falsely increase serum potassium Step 2: Get an EKG * Earliest EKG change* Peaked T waves* Late EKG changes* Flattened P wave* Prolonged QRS* Critical/Emergent EKG changes* Sine wave Step 3: Protect the Heart * EKG Changes = Give Calcium* Calcium gluconate (can be given IV)* Stabilizes the myocardium against dysrhythmia Step 4: Shift Potassium Into Cells * Insulin (plus D50)* Albuterol Step 5: Remove Potassium from Body * Kayexalate* Notorious for causing intestinal necrosis* Falling out of favor* Furosemide Additional Reading * Round 8 – Fall (EM Clerkship)* Emergency Management of Hyperkalemia (EM Cases)