Hyperkalemia

Summary: <br> Hyperkalemia = EKG… EKG changes = Calcium…<br> <br> <br> <br> Step 1: Recheck the Potassium<br> <br> <br> <br> * 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<br> <br> <br> <br> Step 2: Get an EKG<br> <br> <br> <br> * Earliest EKG change* Peaked T waves* Late EKG changes* Flattened P wave* Prolonged QRS* Critical/Emergent EKG changes* Sine wave<br> <br> <br> <br> Step 3: Protect the Heart<br> <br> <br> <br> * EKG Changes = Give Calcium* Calcium gluconate (can be given IV)* Stabilizes the myocardium against dysrhythmia<br> <br> <br> <br> Step 4: Shift Potassium Into Cells<br> <br> <br> <br> * Insulin (plus D50)* Albuterol<br> <br> <br> <br> Step 5: Remove Potassium from Body<br> <br> <br> <br> * Kayexalate* Notorious for causing intestinal necrosis* Falling out of favor* Furosemide<br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * Round 8 – Fall <a href="http://www.emclerkship.com/round-8-fall/">(EM Clerkship)</a>* Emergency Management of Hyperkalemia <a href="https://emergencymedicinecases.com/emergency-management-hyperkalemia/">(EM Cases)</a><br>