Hyperkalaemia Flashcards
1
Q
You receive a call from the surgical ward about a patient who is 2 days post small bowel resection for adhesions and ischaemic gut. You are told the patient is looking well but their blood tests show a potassium of 6.5mmol/L (3.5-5.5). How would you manage this?
A
Impression
This patient has hyperkalaemia, which is immediately concerning for cardiac arrhythmias, muscle weakness and sudden death.
The cause of this man’s hyperkalaemia should also be investigated;
- increased cell turnover (TLS, rhabdo, burns)
- change in distribution: acidosis, insulin deficiency, dehydration/reduced oral intake
- reduced excretion: renal disease/AKI
- pseudohyuperkalaemia (prolonged tourniquet, or haemolysis)
Goals
- Emergent assessment taking A to E and mitigating risks for cardiac arrhythmias
- Manage hyperkalaemia emergently
- assess for underlying cause and definitively manage
2
Q
Hyperkalaemia - Assessment
A
Assessment
A -
B -
C - IVC access, serial ECG and BP/HR monitoring. administer fluids, calcium gluconate for cardiac membrane stabilisation, consider insulin-dextrose infusion to place
