How is hyperkalemia (high serum potassium level) treated in the prehospital setting?

Updated: Apr 09, 2020
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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In the prehospital setting, a patient with known hyperkalemia or a patient with renal failure with suspected hyperkalemia should have IV access established and should be placed on a cardiac monitor. [21] In patients with hypotension or marked QRS widening, IV bicarbonate, calcium, and insulin given together with 50% dextrose may be appropriate (see Medication). If digoxin toxicity is suspected, avoid calcium; instead, give magnesium sulfate (2 g over 5 minutes) for patients with cardiac arrhythmias from digitalis toxicity.

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