Severe HYPERKALEMIA Management Algorithm

Severe HYPERKALEMIA Management Algorithm Does patient have Severe HYPERKALEMIA ? 1) K> mEq/L, 2) risk factors for, 3) clinical Do not apply symptoms/signs* of, AND 4) ECG changes* consistent with HYPERKALEMIA NO. this Algorithm YES *see back page for symptoms, signs and ECG findings Place patient on cardiopulmonary monitor; obtain ECG (if not already done) Definitions: Place patient on ZOLL defibrillator; CPR board immediately available Normal K+ levels are mEq/L. Manage airway as clinically indicated Mild HYPERKALEMIA : mEq/L. Obtain IV/IO access or access central line (CVC, port, PICC) if present Moderate HYPERKALEMIA : mEq/L. Obtain blood1: I-stat, renal, Ca, Phos, Mg, CK, and cortisol; urine for UA Severe HYPERKALEMIA : > mEq/L. Search for & treat underlying cause, if known. Remove any K+ going to the patient (TPN or IVF). 1st: Methods to decrease myocardial excitability IV calcium - to stabilize the myocardium and prevent arrhythmia Peripheral access: Calcium gluconate 50 mg/kg IV over 5 minutes via pump o not a one-step med, MD orders in EPIC.

IV insulin and dextrose Dextrose 0.5 gm/kg (max 25 grams) as D25W (or D10W in neonates) COMBINED WITH Regular Insulin 1 unit for every 4-5 grams of Dextrose (max 5 units insulin) In One Bag. Infuse over 60 – 120 minutes. o Use “Hyperkalemia” order set (not an “ED” order set yet) o Order STAT from pharmacy

Loading..

Tags:

  Management, Insulin

Information

Related search queries