|
Emergency treatment of hyperkalemia is targeted towards one of three objectives:
 |
Antagonizing
calcium, eg Calcium Chloride administration |
|
Causing
potassium to shift into cells, eg with administration of sodium bicarbonate, insulin + glucose, or nebulized albuterol |
|
Removing
potassium from the body, eg with diuresis with a non-potassium-sparing diuretic, administration of cation exchange resin,
or dialysis |
Therapy |
Dose |
Onset
of Effect |
Duration
of Effect |
| Calcium
chloride |
5-10
ml IV of 10% solution (500-1000mg |
1-3
minutes |
30-60
minutes |
| Sodium
bicarbonate |
1
mEq/kg IV bolus |
5-10
minutes |
1-2
hours |
| Insulin
plus glucose (use 1 unit of insulin/2.5 g glucose) |
Regular
insulin 10 U IV plus 50 ml D50 (25 g glucose) IV bolus |
30
minutes |
4-6
hours |
| Nebulized
albuterol |
10-20
mg nebulized over 15 minutes |
15
minutes |
15-90
minutes |
| Furosemide |
40-80
mg IV bolus |
With
onset of diuresis |
Until
diuretic effect ends |
| Kayexalate |
15-50
g PO or PR, plus sorbitol |
1-2
hours |
4-6
hours |
| Peritoneal
dialysis or hemodialysis |
Per
institution |
Immediate |
Until
dialysis completed |
* - Information taken from Handbook of Hazinski, M et al, eds. Emergency Cardiovascular
Care for Healthcare Providers 2002, produced by the American Heart Association.
|
