Hyperkalemia resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; associate editor-in-chief: Mahmoud Sakr, M.D. [2]
Definition
Hyperkalemia is best defined as a serum potassium concentration greater than 5.5 mEq/L in adults; levels higher than 7 mEq/L can lead to significant hemodynamic compromise
Causes
Life-Threatening Causes
Immediate life-threatening causes are conditions which result in immediate death or disability if left untreated.
- Acute Renal Failure
- Rhabdomyolysis
- Rapid tissue necrosis
- Tumor Lysis syndrome
- Metabolic acidosis
- Massive hemolysis
- large IV doses of Calcium chloride or calcium gluconate
- Adrenal insufficiency
Common Causes
Management
Please find below an algorithm that summarizes the approach to hyperkalemia
Check vital signs Stabilize the patient Order an EKG Concise history and physical exam | |||||||||||||||||||||||||||||||||||||||||||||||||||
Assess EKG | |||||||||||||||||||||||||||||||||||||||||||||||||||
EKG consistent with ACS | EKG not consistent with ACS | ||||||||||||||||||||||||||||||||||||||||||||||||||
Order a CXR | |||||||||||||||||||||||||||||||||||||||||||||||||||
STEMI Revascularization | NSTEMI Risk stratification | ||||||||||||||||||||||||||||||||||||||||||||||||||
Pneumothorax | Aortic dissection | No significant findings on CXR | |||||||||||||||||||||||||||||||||||||||||||||||||
Control BP Obtain a CT scan Emergent surgery consult | Assess the pretest probability forpulmonary embolism | ||||||||||||||||||||||||||||||||||||||||||||||||||