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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

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sábado, 11 de enero de 2020

Hyperkalemia

The BREACH, EM research bulletin
The Breach - By Barrie Stevenson - January 7, 2020
"Problem 1: Too much insulin
Take home points
  1. Treating hyperkalaemia with insulin will cause blood glucose levels to fall, even if you co-administer dextrose
  2. The drop in blood glucose is highly variable, but may be as much as 2.9mmol/L (53mg/dL)
  3. The effects of IV dextrose will wear off before those of insulin, so check blood glucose after 1-2 hours
Problem 2: Too little calcium
Take home points
  1. Use 10% calcium gluconate unless you have a central line. Give 3 sequential doses of 10ml until the ECG normalises
  2. Only give calcium if there are ECG changes associated with hyperkalaemia
  3. The duration of action is 30-60min, so be ready to repeat the dose if ECG changes reappear"