Hyperkalemia Medical Directive

Question 1

Hyperkalemia Medical Directive
Indications

theres a lot

Answer 1

Suspected hyperkalemia in patients at high risk
including
currently on dialysis
OR
History of end-stage renal disease
OR
Relevant incident History (prolonged crush injury, major burns, status seizures, prolonged immobilization

AND

Cardiac Arrest
OR
Pre-arrest with 12 lead ECG changes associated with hyperkalemia

Question 2

Calcium Gluconate 10%
Conditions
Age?

Answer 2

Age: ≥ 18 years

Question 3

Salbutamol
Conditions
Age?

Answer 3

Age: ≥ 18 years

Question 4

Calcium Gluconate 10%
Route - IV / IO / CVAD
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?**

Answer 4

Dose: 1g (10ml) over 2 - 3 minutes
Max. Single Dose: 1g (10ml)
Dosing Interval: 5 minutes
Max # of Doses: 2

additional 3rd dose may be administered after 30minutes if patient improved initially and symptoms meeting the indications recur

Question 5

Salbutamol
Route - MDI
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?

Answer 5

Dose: 1,600mcg (16 puffs)
Max. Single Dose: 1,600mcg
Dosing Interval: Immediate
Max # of Doses: 2

Question 6

Salbutamol
Route - NEB
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?

Answer 6

Dose: 10mg
Max. Single Dose: 10mg
Dosing Interval: Immediate
Max # of Doses: 2

Question 7

12 Lead Changes associated with HypkerKalemia?

Answer 7

1. Wide Bizarre QRS ≥120ms
2. Peaked T waves
3. Loss of P waves
4. QRS sine wave appearance

Question 8

Pre-arrest Hyperkalmemic patient would present with one or more of the following?

Answer 8

1. Hypotension
2. Altered level of awareness
3. symptomatic bradycardia