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Hyperkalemia Treatment

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Hyperkalaemia / hyperkalemia is a potentially life-threatening electrolyte abnormality. In this series, we explore the causes, consequences and treatment options for hyperkalaemia.

Welcome back you might be joining us from our first video on hyperkalemia when we talked about potassium homeostasis and welcome throw it out of whack today we’ll be talking about how we treat hyperkalemia so let’s imagine that a patient is presented to you in the emergency department with a dangerous hyperkalemia to find some potassium in excess of 6.5 our patient

Today is portrayed by worf from star trackers that’s just – i felt like drawing today you’ll discover wolf’s potassium of eight by one of two methods either because you’re handed a blood test that confirms it or because you’re handed an ecg showing the typical abnormalities discussed in our first video you must first act quickly to get the next urgent test done

If you’ve seen the blood test you must get an ecg to see whether that dangerous arrhythmia is developing if you’ve done the ecg you must get an urgent blood test ideally a point-of-care one to confirm the hyperkalemia if there is evidence of cardiac instability on the ecg in the presence of hyperkalemia the first treatment is usually calcium gluconate or calcium

Chloride calcium won’t bring your potassium back down to normal but it can stabilize the myocardium telling those overexcited heart muscle cells to calm down you may need to give more than one treatment to ensure those ecg changes have resolved once you stabilize the heart you need to bring the potassium down quickly and safely it’s difficult to get potassium

Out of the body quickly so like sweeping dust under a rug we push that potassium into the cells two drugs are commonly used to do this one is salbutamol a beta agonist given as a nebulizer the other is insulin typically given alongside dextrose to prevent the hormone from simultaneously dropping your blood sugar both encourage cells to take up potassium from

The interstitial driving down potassium in the extracellular space and remedying the problem forever hmm not quite it’s critical to remember that this is a temporary fix as the drug clears potassium will diffuse back into the interstitial pushing your plasma potassium back up into the danger zone your next step therefore is to monitor the response to treatment

As a recurrent hyperkalemia is a very common problem the best and most effective treatment is to treat the underlying cause if spyro is turning down your sodium potassium pump it needs to be stopped to allow potassium excretion to resume if an acute kidney injury can be reversed it should be as you need the kidneys back in the game to flush that potassium ounce

If the kidneys aren’t working either due to a very severe acute injury or chronic end-stage disease you might find yourself with refractory hyperkalemia high potassium that doesn’t respond to the treatments that we’ve talked about these patients may need dialysis the use of an artificial kidney to clear the potassium from the blood how this works is beyond the

Scope of today’s video but it’s important to remember it as an option in the event that these other treatments haven’t worked sometimes patients with chronic kidney disease are given a drug called calcium reso neum this binds to potassium and keeps it out of the way so let’s recap if you are handed a venous gas with a raised serum potassium and you’re confident

It’s not a hemolyzed sample act quickly to get an ecg and treat according to your local guidelines you must identify and address the cause remembering to monitor the potassium regularly during treatment and that’s all i’ve got to say about that hope you found this whistlestop tour of potassium useful we’ll be back very soon with some more videos and in the meantime

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Transcribed from video
Hyperkalemia Treatment By HippocraTV