Hyperkalemia

🔑 Key Priorities

  • Stabilise myocardium

  • Shift potassium intracellularly

  • Enhance potassium elimination

🧠 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

🧭 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)

🔄 Ideal Crisis Flow

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

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