Correction of Hyperkalemia 📚

🧠 meaning

Hyperkalemia = a condition where blood potassium levels are greater than 5.0 mEq / L.

It's considered dangerous because potassium has a direct effect on the conduction of the heart.

➡ Arrhythmia or cardiac arrest can occur.

⚡ common cause.

1.Drive K Out Less - Kidney Failure, Use ACEI / ARB Group Drug, Spironolactone

2.K Move out of the cell - acidosis, muscle injury / breakdown (rhabdomyolysis)

3.Get K Exceed - from food or water substance with high K, mass blood feeding

❤️ found ECG.

• Tall peaked T wave

• Long interval PR

• Wide QRS

• It can become a sine-wave pattern → cardiac arrest.

🚨 Principles of Hyperkalemia Treatment

The treatment is divided into 4 main steps, according to the goal "Prevent the heart - Move potassium - Expel potassium - Solve the cause."

🩺 1. Prevent cardiac arrest.

Reduced the effect of K on heart muscle, but did not reduce the actual K level.

→ Calcium Gluconate 10% (10 mL IV in 2-5 minutes)

• Acting within 1-3 minutes, lasts ~ 30-60 minutes

• Use in the presence of abnormal ECG or K ≥ 6.5 mEq / L

• Do not inject muscles / Do not accompany NaHCO along the same way

💡. If there is no ECG change →, there is no need to give.

🧬 2.Move potassium into cells (Shift K into cells)

To temporarily reduce the level in the blood.

- Insulin + Dextrose

Regular insulin 10 units IV + 50% Dextrose 50 mL

Insulin allows K to enter the cell

- Obi ❣ -agonist (Salbutamol neb.)

10-20 mg nebulizer

Stimulate Na / K pump

- NaHCO (in metabolic acidosis)

50 mEq IV slow

Add pH → K to cell

💧 3. Expel potassium from the body (Remove K from body)

Real K level reduction

- Loop diuretic (Furosemide) increased urinary K driving

Must see if the patient can urinate.

- Sodium polystyrene sulfonate (Kayexalate) binds K in intestine, excretes through feces, acts slowly (2-6 hours)

- Hemodialysis, the fastest and surest method. Use in case of kidney failure or treatment resistance.

🧩 4.Fix the cause of high K

• Stop K-added drugs (ACEI, ARB, Spironolactone, KCl supplements, etc.)

• Treatment of renal failure / acidosis

• Adjust food, reduce potassium

📋 Simple Remember Summary "Hyperkalemia Treatment Procedure Sequence"

1️⃣ Protect heart → Calcium gluconate

2️⃣ Shift K into cells → Insulin + Dextrose / Salbutamol / NaHCO

3️⃣ Remove K from body → Furosemide / Kayexalate / Dialysis

4️⃣ Find and fix cause.

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