High serum potassium levels | ACLS-Algorithms.com

Comments

  1. cancelm5 says

    wow hey have used this site for while now and never ran into this info tab on the tx of hyper/hypo k.. very easy to follow.. can it be printed?

  2. Aisha Ali says

    very good… very informative. I know most of what has been said..but it still nice to read the detail .. and given in such a succint manner. thank you.

  3. Yolanda Wiid says

    What must potassium levels be to be classified as mild, moderate or severe hyperkalemia?
    Kind regards

  4. flieswithsun says

    Arrhythmias, Emergent
    Indicated for arrhythmias associated with hypocalcemia, hyperkalemia, or hypermagnesemia

    Calcium Chloride
    500-1000 mg IV over 2-5 minutes

    1 g (10 mL) vials of calcium chloride 10% solution in the crash cart = 100mg/ml. Usually the doc just asks for an amp.

  5. Rachel Situmorang says

    How to give the D50W with insulin + 10 U insulin in 15-30 minutes? Infusion? Or slow IV bolus?

  6. Solomon Wai says

    I think one of the major reasons why Calcium Chloride is preferred over Calcium Gluconate in Cardiac Arrest is because Calcium Gluconate needs liver metabolism to extract Calcium whike Calcium Chloride dissociate into Ca++ and Cl- once it hits the plasma.

  7. Christena says

    I see that the AHA guidelines recommend insulin + D50 over 15-30 minutes for the treatment of severe hyperkalemia. It seems that this would require the two components to be mixed in an empty minibag or drawn up in a syringe and put on a pump for infusion? During a code this does not seem practical. Honestly, I have never seen it infused this slowly. I almost always see the insulin pushed, then the D50W pushed, or the reverse (or no D50 if bg is severely elevated). Do you know the rationale for the slow infusion of 15-30 minutes and how this would practically work during a cardiac arrest scenario, especially if you were not planning on giving the dextrose due to severe hyperglycemia?
    Thank you,
    Christena

    • Jeff with admin. says

      I have always seen it pushed in a code situation. No reason for a slow infusion on a dead person.
      The 15-30 min amiodarone infusion that the guidelines address is for a non-coding patient with a tachyarrhythmia that is being treated with amiodarone.

      Kind regards,
      Jeff

  8. heather says

    Is there evidence-based support for calcium chloride over calcium gluconate? I don’t see why gluconate (of course at an equivalent dose) is not an option. Thanks.

  9. Louise Fowler says

    ACLS is now recommending using 100ml of 10% glucose for hypoglycaemia however it is still recommending 50% glucose 10units of insulin for hyperkalaemia. Can we use 250ml of 10% glucose for hyperkalaemia?? Kind Regards

    • Jeff with admin. says

      Toward the bottom of this webpage, your first question is addressed. Regarding your second question, I could not find any information about using 250ml of D10 instead of the 50ml of D50. If D50 was not available, I see no reason why this would be a problem since you would be giving an equal about of dextrose, but the fluid volume would be slightly more.

      Kind regards,
      Jeff

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