Electrolyte Disturbances - Potassium - Hyperkalemia
3 important questions on Electrolyte Disturbances - Potassium - Hyperkalemia
First treatment of hyperkalemia with ECG abnormalities
- Calcium chloride 10% 5-10 ml in 5-10 minutes (to stabilize myocardial cell membrane and decrease potential for arrhythmias)
Effect only lasts 30-60 minutes > additional treatment
Treatment of hyperkalemia (redistribution) (3)
- Insuline and glucose (10 EH insuline with 50 g of 50% glucose over 5-10 min IV) > monitor glucose!
- Sodium bicarbonate (1 mmol/kg IV in 5-10 min) > less effective than 1. and in patients with end-stage renal failure
- Inhalation B2-agonist (salbutamol, 10-20 mg) > decrease of 0.5 mmol/L
Treatment of hyperkalemia (removal) (3)
- Increase urine output with loop diuretic (furo 1-2 mg/kg) and isotonic fluids
- Increase GI potassium loss with resonium or sorbitol (25-50 g)
- Initiate dialysis
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