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Pathology
Raised blood potassium concentration >5.5mmol/L
Aetiology
Increased production: Excess potassium therapy, blood transfusion
Decreased excretion: Renal failure, hypoaldosteronism, Addison’s disease
Release from cells: DKA, metabolic acidosis, burns, rhabdomyolysis
Drugs: Potassium sparing diuretics, Beta blockers, ACE inhibitors, NSAIDS,
Potassium supplements
Signs
Ventricular Fibrillation, Kussmaul’s breathing
Symptoms
Non-specific e.g. nausea, malaise, muscle weakness.
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 degree of hyperkalaemia with ECG changes - urgent treatment
tabilise Myocardium: 10ml 10% IV calcium gluconate
To lower K+: 10 units of Insulin in 50mls 50% Dextrose, Salbutamol nebuliser
Calcium Resonium. Haemodialysis in severe cases
Prognosis
Depends on aetiology
Sudden deathKey Facts
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