RRAPID: Hyperkalaemia Flashcards
1
Q
Define Hyperkalaemia?
A
Serum K > 5 mmol/L
2
Q
Causes? (10)
A
Oliguric AKI K sparing diuretics (spirolanactone, amiloride) Vomiting (young patient) Drugs (ACE-i) = reduced secretion of K+ Rhabdomyolysis Metabolic acidosis Iatrogenic (excess K infusion) Addison's disease Massive blood transfusion Artefact (haemolysis)
3
Q
Symptoms? (7)
A
Fast irregular pulse Chest pain Weakness Numbness paraesthesia Confusion Arrthymias Palpitations
4
Q
Response?
A
ABCDE
5
Q
Response (Circulation)?
A
IV access - bloods: FBC, U&E’s, LFT’s, glucose)
ECG
6
Q
What are ECG changes regarding hyperkalaemia? (4)
A
Tall tented T waves
Small P waves
Wide QRS complex becoming sinusoidal
VF
7
Q
Immediate treatment is required if…? (2)
A
K > 6 mmol/L with ECG changes
OR
K > 6.5 mmol/L regardless of ECG changes
8
Q
Temporary medication Mx? (until underlying cause can be treated)
A
Calcium gluconate:
- 10% calcium gluconate 30 mls IV over 2 mins OR 10% calcium chloride 10mls over 10 mins.
- Repeat dose after 5-10 mins if no ECG improvement.
- Provides cardio-protection – no change in serum potassium level.
Insulin & Glucose:
- Short acting insulin 10 units in 50mls of 50% glucose IV over 5-10 mins.
- Insulin shifts potassium into cells temporarily
- Monitor blood sugar levels regularly.
Salbutamol nebuliser:
- Salbutamol 10-20mg (5mg back to back) over 10-20 mins
- Shifts potassium into cells temporarily
Calcium Resonium:
- 15mg orally every 6-8hrs
- removes potassium from GI tract
9
Q
What is the Mx for intractable cases of hyperkalaemia?
A
Renal replacement therapy
