Test Findings
 

Hyperkalaemia

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Overview

  • Hyperkalaemia is an elevated serum potassium level that can predispose to cardiac arrhythmias.
    • Look For

    • Serum potassium >5.0mmol/L.

Aetiology

    • Causes of Hyperkalaemia

    • Factitious

    • Haemolysis (e.g. poor collection, delay in lab processing)
    • Leukocytosis / thrombocytosis
    • Increased Intake / Production

    • Exogenous administration - massive transfusion, potassium supplements, TPN
    • Endogenous production - rhabdomyolysis
    • Reduced Excretion

    • Renal failure - acute or chronic
    • Medications - NSAIDs, ACE inhibitors, ARBs, spironolactone, trimethoprim
    • Addison’s
    • Compartmental Shift

    • Type 4 renal tubular acidosis
    • Metabolic acidosis
    • Hyperglycaemia
    • Beta blockers
    • Trauma / burns

Clinical Features

    • Signs and Symptoms

    • Paraesthesia
    • Flaccid paralysis
    • Hypotension
    • Bradycardia
    • Arrhythmia
    • ECG Changes

    • Tall (tented) T-waves
    • QRS widening
    • Loss of P waves
    • Sine waves
    • VT / VF / asystole
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