Hyperkalemia

🔑 Key Priorities

• Stabilise myocardium

• Shift potassium intracellularly

• Enhance potassium elimination

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🧠 Team Actions

Role	Task
Team Leader	Direct ECG monitoring and drug sequence
Circulation	IV access, ECG, administer calcium and insulin
Drug Assistant	Draw up insulin, dextrose, salbutamol

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🧭 Management Algorithm

1. Confirm with ECG (peaked T waves, wide QRS)

2. Stabilise myocardium:

   • Calcium chloride 10mL 10% over 5–10 min

3. Shift K⁺ intracellularly:

   • Actrapid 10 units IV + 50 mL of 50% dextrose

   • Nebulised salbutamol 10–20 mg

   • Sodium bicarbonate 50 mEq if acidotic

4. Eliminate K⁺:

   • Frusemide, consider dialysis

5. Treat cause (rhabdomyolysis, acidosis, drugs)

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🔄 Ideal Crisis Flow

              Hyperkalaemia
                   ↓
         ECG Monitoring + Call Help
                   ↓
     Calcium + Insulin/Dextrose + Salbutamol
                   ↓
      Eliminate K⁺ + Address Underlying Cause
                   ↓
       Dialysis if Refractory or Renal Failure