Hyperkalaemia

Question 1

Complication?

Answer 1

cardiac arrhythmias such as ventricular fibrillation –> fatal

Question 2

ECG signs?

Answer 2

• Tall peaked T waves
• Flattening or absence of P waves
• Broad QRS

Question 3

At what K level is it essential to initiate Mx?

Answer 3

K >6mmol/L and ECG changes requires urgent treatment

>6.5mmol/L require urgent treatent regardless of ECG

Question 4

Mx?

Answer 4

Mainstay= Insulin Dextrose solution AND IV Calcium Gluconate

• Insulin & dextrose stimulate cellular uptake of K
• Ca gluconate reduces excitability of heart & stabilizes cardiac muscle cells

Other options:

• nebulised salbutamol
• IV fluids
• oral calcium resonium - exchanges calcium ions for K+ ions
  
  • works slowly & is suitable for milder cases of hyperkalaemia
• sodium bicarbonate
• dialysis