Pathology: Raised blood potassiumconcentration >5.5mmol/L
Aetiology: Increased production: Excess potassiumtherapy, blood transfusion
Decreased excretion: Renalfailure, hypoaldosteronism, Addison’s disease
Release from cells: DKA,metabolic acidosis, burns, rhabdomyolysis
Drugs:Potassium sparing diuretics, Beta blockers, ACE inhibitors, NSAIDS,
Potassiumsupplements
Symptoms: Non-specifice.g. nausea, malaise, muscle weakness
Signs: Ventricular Fibrillation, Kussmaul’s breathing
Investigations: Bloods: FBC, U+E’s
ECG:decreased P wave amplitude, tall tented T waves, widening of QRS complex
ABG: May show acidosis
Treatment: Treat underlying cause
K+ of >6.5 and any degreeof hyperkalaemia with ECG changes - urgent treatment
StabiliseMyocardium: 10ml 10% IV calcium gluconate
To lower K+: 10units of Insulin in 50mls 50% Dextrose, Salbutamol nebuliser
CalciumResonium. Haemodialysis in severe cases
Complications: Sudden death
Prognosis: Depends on aetiology
Figure 1.11 ECG findings of Hyperkalaemia
