Patient Safety Alert Issued Over High Levels of Potassium 

Nicky Broyd

August 09, 2018

A patient safety alert has been issued to all 232 NHS trusts and GP practices in England warning that high potassium levels (hyperkalaemia) are a potentially life-threatening emergency.

It follows 35 reports over 3 years to the NRLS (National Reporting and Learning System) of people who had high levels of potassium in their blood and who went on to have a cardiac arrest. Most were adults but one was a child and one a baby.

The most common causes of hyperkalaemia are kidney disease and heart-related problems, like high blood pressure. However, high levels of potassium can affect people with a range of conditions.

Potential Emergency - Don't Delay

The alert comes from NHS Improvement and has been issued alongside guidance. It says arrhythmias and cardiac arrest can happen quickly, without warning, and even if the patient looks well, and advises NHS staff not to delay and to treat all people with high levels of potassium in their blood as emergencies.
It says the number of reports of cardiac arrest suggests that some healthcare professionals may not appreciate that clinical assessment, treatment, and ongoing monitoring of hyperkalaemia is time critical.

Dr Kathy McLean, executive medical director and chief operating officer at NHS Improvement said in a news release: "High blood potassium levels are extremely dangerous and can lead to cardiac arrest.

"It is vital that patients with high potassium levels in their blood are treated as an emergency and given treatment quickly and monitored."


As soon as possible NHS improvement wants all NHS organisations who receive and review blood test results to:

  • Identify a senior clinician in the organisation who can lead the response to its alert on high potassium levels

  • Produce (or review) local guidance for the management of hyperkalaemia and ensure that the guidance can be easily accessed by all staff, including bank and agency staff

  • Ensure relevant guidance and resources are embedded in clinical practice by revising local training

  • Use local communication strategies (such as videos, newsletters, local awareness campaigns, etc.) to make all staff aware that hyperkalaemia is a potentially life-threatening emergency and that its timely identification, treatment and monitoring during and beyond initial treatment is essential.

It says while GP practices will not need hyperkalaemia treatment protocols or equipment, they will need to ensure they implement all actions that will support the correct response to any blood test results they receive indicating hyperkalaemia.

NHS improvement has given organisations 9 months to make sure the actions above are completed.


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