Hyperkalemia management in the emergency department: An expert panel consensus
Bischof, Jason J
Weir, Matthew R
JournalJournal of the American College of Emergency Physicians Open
MetadataShow full item record
AbstractHyperkalemia is a common electrolyte abnormality identified in the emergency department (ED) and potentially fatal. However, there is no consensus over the potassium threshold that warrants intervention or its treatment algorithm. Commonly used medications are at best temporizing measures, and the roles of binders are unclear in the emergent setting. As the prevalence of comorbid conditions altering potassium homeostasis rises, hyperkalemia becomes more common, and hence there is a need to standardize management. A panel was assembled to synthesize the available evidence and identify gaps in knowledge in hyperkalemia treatment in the ED. The panel was composed of 7 medical practitioners, including 5 physicians, a nurse, and a clinical pharmacist with collective expertise in the areas of emergency medicine, nephrology, and hospital medicine. This panel was sponsored by the American College of Emergency Physicians with a goal to create a consensus document for managing acute hyperkalemia. The panel evaluated the evidence on calcium for myocyte stabilization and potassium shifting and excretion. This article summarizes information on available therapies for hyperkalemia and proposes a hyperkalemia treatment algorithm for the ED practitioner based on the currently available literature and highlights diagnostic pitfalls and evidence gaps.
Rights/Terms© 2021 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/16857
- An Evidence-Based Narrative Review of the Emergency Department Management of Acute Hyperkalemia.
- Authors: Lemoine L, Le Bastard Q, Batard E, Montassier E
- Issue date: 2021 May
- Acute hyperkalemia in the emergency department: a summary from a Kidney Disease: Improving Global Outcomes conference.
- Authors: Lindner G, Burdmann EA, Clase CM, Hemmelgarn BR, Herzog CA, Małyszko J, Nagahama M, Pecoits-Filho R, Rafique Z, Rossignol P, Singer AJ
- Issue date: 2020 Oct
- Emergency management of severe hyperkalemia: Guideline for best practice and opportunities for the future.
- Authors: Rossignol P, Legrand M, Kosiborod M, Hollenberg SM, Peacock WF, Emmett M, Epstein M, Kovesdy CP, Yilmaz MB, Stough WG, Gayat E, Pitt B, Zannad F, Mebazaa A
- Issue date: 2016 Nov
- Is Transcellular Potassium Shifting With Insulin, Albuterol, or Sodium Bicarbonate in Emergency Department Patients With Hyperkalemia Associated With Recurrent Hyperkalemia After Dialysis?
- Authors: Driver BE, Klein LR, Chittineni C, Cales EK, Scott N
- Issue date: 2018 Jul
- Recommendations for the management of hyperkalemia in the emergency department.
- Authors: Álvarez-Rodríguez E, Olaizola Mendibil A, San Martín Díez MLÁ, Burzako Sánchez A, Esteban-Fernández A, Sánchez Álvarez E
- Issue date: 2022 Aug