Hyperkalemia management in the emergency department: An expert panel consensus

Journal of the American College of Emergency Physicians Open

Frank Peacock¹  Zubaid Rafique¹  Matthew R. Weir²  Terra Armstead³  Jason J. Bischof⁴  James Neuenschwander⁴  Joanna Hudson⁵ 

[1] Baylor College of Medicine Department of Emergency Medicine Ben Taub General Hospital Houston Texas USA;Division of Nephrology Department of Medicine University of Maryland School of Medicine Baltimore Maryland USA;Muskingum University New Concord Ohio USA;The Ohio State University Department of Emergency Medicine Columbus Ohio USA;The University of Tennessee Health Science Center Departments of Clinical Pharmacy and Translational Science & Medicine (Nephrology) Memphis Tennessee USA;

关键词: acute management;    algorithm;    consensus recommendation;    hyperkalemia;   

DOI  :  10.1002/emp2.12572

来源: DOAJ

【 摘 要 】

Abstract Hyperkalemia 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.

【 授权许可】

Unknown