Treatment of Severe Hyperkalemia*

• Reverse Membrane Effects
  • Calcium (10% calcium chloride IV over 10 min)
• Transfer Potassium Into Cells
  • Glucose (D10W) and regular insulin (5–10 U regular insulin for every 25–50 g of glucose)
  • Sodium bicarbonate (50–100 mEq over 5–10 min)
  • β₂-agonists
• Remove Potassium from Body
  • Diuretics (proximal or loop)
  • Potassium-exchange resins
  • Hemodialysis (removes 25–50 mEq/hr)

*>7 mEq/L, ECG changes.

D10W = 10% dextrose in water; ECG = electrocardiograph; IV = intravenous.