Hyperkalemia in Emergency Medicine Questions & Answers

Updated: Aug 06, 2019
  • Author: David Garth, MD; Chief Editor: Erik D Schraga, MD  more...
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Questions & Answers

Overview

What is the role of electrocardiography in the workup of hyperkalemia (high serum potassium level)?

What potassium concentration constitutes hyperkalemia (high serum potassium level), and why is the condition difficult to diagnose?

What are the symptoms of hyperkalemia (high serum potassium level)?

What are the essential components of the physical exam in suspected hyperkalemia (high serum potassium level)?

Which lab studies are used in the diagnosis of hyperkalemia (high serum potassium level)?

What prehospital care is indicated in suspected hyperkalemia (high serum potassium level)?

What is the emergency department assessment and treatment for hyperkalemia (high serum potassium level)?

What is the emergency department treatment for severe hyperkalemia (high serum potassium level)?

What is the role of dialysis in the treatment of hyperkalemia (high serum potassium level)?

Which drugs are used in the treatment of hyperkalemia (high serum potassium level)?

When should hyperkalemia (high serum potassium level) be considered as a diagnosis?

What is the physiology of potassium?

How is hyperkalemia (high serum potassium level) defined?

What causes hyperkalemia (high serum potassium level)?

What is the prevalence of hyperkalemia (high serum potassium level) in the US?

Is hyperkalemia (high serum potassium level) more common in males or females?

What causes morbidity in hyperkalemia (high serum potassium level) and what is the mortality rate?

Which factors increase the risk for mortality in hyperkalemia (high serum potassium level)?

Presentation

What is the role of patient history in the diagnosis of hyperkalemia (high serum potassium level)?

When is hyperkalemia (high serum potassium level) usually identified?

Which symptoms are most common in hyperkalemia (high serum potassium level)?

Which symptoms are consistent with hyperkalemia (high serum potassium level)?

Which conditions increase the risk of hyperkalemia (high serum potassium level)?

How are vital signs used in the evaluation of hyperkalemia (high serum potassium level)?

Which cardiac findings suggest hyperkalemia (high serum potassium level)?

Which neurologic findings suggest hyperkalemia (high serum potassium level)?

Which physical findings may suggest hyperkalemia (high serum potassium level)?

What should be the focus of the physical exam in suspected hyperkalemia (high serum potassium level)?

What causes pseudohyperkalemia?

What causes redistribution in hyperkalemia (high serum potassium level)?

What are the endogenous causes of hyperkalemia (high serum potassium level)?

What are the exogenous causes of hyperkalemia (high serum potassium level)?

What causes diminished potassium excretion in hyperkalemia (high serum potassium level)?

When should lab studies be repeated in the workup of hyperkalemia (high serum potassium level)?

DDX

What are the differential diagnoses for Hyperkalemia in Emergency Medicine?

Workup

How are elevated serum potassium levels manifested in hyperkalemia (high serum potassium level)?

Which lab studies are indicated in the workup of hyperkalemia (high serum potassium level)?

When is continuous cardiac monitoring indicated in the workup of hyperkalemia (high serum potassium level)?

What is the role of ECG in the workup of hyperkalemia (high serum potassium level)?

Which ECG findings are characteristic of hyperkalemia (high serum potassium level)?

When are cortisol and aldosterone levels measured in the workup of hyperkalemia (high serum potassium level)?

Treatment

What is the prehospital treatment for hyperkalemia (high serum potassium level)?

What monitoring should be done in the emergency department for hyperkalemia (high serum potassium level)?

What is the initial management of hyperkalemia (high serum potassium level)?

What is the emergency department treatment for hyperkalemia (high serum potassium level)?

What is the role of sodium polystyrene sulfonate (SPS) in the treatment of hyperkalemia (high serum potassium level)?

What are the roles of patiromer (Veltassa) and sodium zirconium cyclosilicate (ZS-9) in the treatment of hyperkalemia (high serum potassium level), and what is the frequency of hypoglycemia associated with insulin administration?

When are specialist consultations indicated in the treatment of hyperkalemia (high serum potassium level)?

Medications

What is the goal of treatment of hyperkalemia (high serum potassium level)?

Which medications in the drug class Electrolytes are used in the treatment of Hyperkalemia in Emergency Medicine?

Which medications in the drug class Binding resins are used in the treatment of Hyperkalemia in Emergency Medicine?

Which medications in the drug class Diuretics are used in the treatment of Hyperkalemia in Emergency Medicine?

Which medications in the drug class Beta2-adrenergic agonists are used in the treatment of Hyperkalemia in Emergency Medicine?

Which medications in the drug class Alkalinizing agents are used in the treatment of Hyperkalemia in Emergency Medicine?

Which medications in the drug class Antidotes are used in the treatment of Hyperkalemia in Emergency Medicine?

Which medications in the drug class Electrolyte supplements are used in the treatment of Hyperkalemia in Emergency Medicine?

Follow-up

What outpatient follow-up care is required for hyperkalemia (high serum potassium level)?

What inpatient care is indicated for hyperkalemia (high serum potassium level)?

When is transfer indicated for patients with hyperkalemia (high serum potassium level)?

How can hyperkalemia (high serum potassium level) be prevented?

What are possible complications of hyperkalemia (high serum potassium level)?

What is the prognosis of hyperkalemia (high serum potassium level)?

What education should be provided to patients with hyperkalemia (high serum potassium level)?