Understand the initial treatment of acute hyperkalemia if the ECG shows features of high potassium.


When presented with a patient with high potassium and Electrocardiographic abnormality- Calcium chloride is the drug of choice because its specific action is cardio protection. This fact is asked so commonly that you should not mix this up with the treatments given below. Calcium chloride is more readily available than Calcium gluconate.

Thereafter or in a non emergency situation one can use Insulin/Glucose combination or Sodium Bicarbonate or Albuterol (Salbutamol). These push potassium into the cells therefore reducing serum potassium.

The Potassium binding resin (Sodium polystyrene sulfonate) should be given to everyone as this is the primary medicine to REMOVE  and not just cause a trans-cellular shift of potassium.

If medical measures fail - Dialyze (hemofilter if dialysis not available)