Order Set For Hyperkalemia
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FAQ
A variety of treatment options are considered for the acute management of hyperkalemia, including insulin, ?2-adrenergic agonists (inhaled, nebulized and intravenous), bicarbonate, resins, fludrocortisone, aminopylline and dialysis. In the sections below, we review the evidence for the use of each of these agents.
These data suggest that hypertonic glucose infusion should precede, not follow, the insulin bolus in the management of hyperkalemia. Such an approach is clinically effective and well tolerated, with no hypoglycemic side effects.
Patients with hyperkalemia who have electrocardiographic (ECG) changes, a rapid rate of rise of serum potassium, decreased renal function, or significant acidosis should be urgently treated. Patients with hyperkalemia and characteristic ECG changes should be given intravenous calcium gluconate.
Hyperkalemia with potassium level more than 6.5 mEq/L or EKG changes is a medical emergency and should be treated ingly. Treatment should be started with calcium gluconate to stabilize cardiomyocyte membranes, followed by insulin injection, and b-agonists administration.
