11/24/2023 0 Comments Antidote for high potassium level![]() ![]() Peripheral access: 0.1units/kg with 10mL/kg of glucose 10%. Soluble insulin (Inform responsible consultant and/or paediatric nephrology consultant/ intensive care consultant) If in doubt consult your ward pharmacist, consultant or BNF. Stop or change any potassium raising medications. Stop all potassium containing medications or feeds/food.If severe hyperkalaemia (potassium >7.0mmol/L or presence of ECG changes) do not delay treatment to repeat the sample. Recheck result with free flowing venous sample.Ensure the patient is placed on a cardiac monitor and that calcium gluconate is given (see above) in the presence of ECG changes and/or if serum potassium > 7mmol/L.Assess the patient, including fluid status and ensure intravascularly replete (give fluids +/- furosemide if appropriate).In a cardiac arrest situation calcium chloride 10% should be used as per the paediatric resuscitation guidelines. Repeat after 5 minutes if persistent ECG changes. Give as a slow IV injection over 5-10 minutes (see the paediatric calcium gluconate IV monograph for dilution and administration details). If there are any of these features present and/or if serum potassium > 7mmol/L give IV calcium gluconate 10% as a membrane stabiliser: 1month - 18 years:Ġ.5mL/kg (0.11mmol/kg) Max. If severe can lead to ventricular fibrillation (VF) and asystole. ![]() Ventricular tachycardia (VT) or sinus bradycardia.Consider creatinine kinase (CK), cortisol, aldosterone, renin, hormone precursor levels and a urine steroid profile.Īll patients should be placed on a cardiac monitor looking for ECG changes of hyperkalaemia.Ĭonduction abnormalities are more likely if there is a rapid rise in potassium, if the patient is acidotic or has co-existing abnormalities in sodium or calcium.Calcium, Magnesium, Bicarbonate, Chloride.Non-steroidal anti inflammatories (NSAIDs) e.g.Can be associated with sickle cell disease, urinary tract obstruction or infection.Pseudohypoaldosteronism (condition characterised by renal tubular unresponsiveness or resistance to the action of aldosterone).Decreased activity of renin-angiotensin-aldosterone system.Hyperkalaemia not usually seen until eGFR is below 30ml/min/1.73m2.Drugs containing high amounts of potassium.High intake due to IV fluids or parenteral nutrition.Hyperventilation ( respiratory alkalosis can cause potassium to move out of the cells).Hereditary spherocytosis and familial pseudohyperkalaemia ( potassium leaks from cells due to cooling).Sample from arm receiving IV fluids containing potassium.The most serious problems caused by hyperkalaemia are cardiac conduction abnormalities and arrhythmias, which are more likely with potassium greater than 7mmol/L or if there has been a rapid change. The urgency of intervention depends on the level of potassium and how rapidly it is increasing, the presence or absence of symptoms and any electrocardiogram (ECG) findings. Severe hyperkalaemia is a potassium greater than 7mmol/L and is a medical emergency and needs immediate attention. Hyperkalaemia is defined as a plasma or serum potassium greater than 5.5mmol/L. ![]() To provide evidence-based recommendations for appropriate diagnosis, investigation and management of hyperkalaemia in paediatric patients aged 1 month - 16 years.įor management of hyperkalaemia in children under 1 month please follow the neonatal guideline.įor management of hyperkalaemia in adults or children aged 16 or over please follow the adult guideline. The aim of this guideline is to help paediatricians, those in secondary care and other allied health care workers detect and manage hyperkalaemia in the paediatric population. Management of hyperkalaemia in children (1 month to 16 years) ![]()
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