Hyperkalemia management in the emergency department: An expert panel consensus
Abstract Hyperkalemia is a common electrolyte abnormality identified in the emergency department (ED) and potentially fatal. However, there is no consensus over the potassium threshold that warrants intervention or its treatment algorithm. Commonly used medications are at best temporizing measures,...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-10-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12572 |
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| _version_ | 1849764620254838784 |
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| author | Zubaid Rafique Frank Peacock Terra Armstead Jason J. Bischof Joanna Hudson Matthew R. Weir James Neuenschwander |
| author_facet | Zubaid Rafique Frank Peacock Terra Armstead Jason J. Bischof Joanna Hudson Matthew R. Weir James Neuenschwander |
| author_sort | Zubaid Rafique |
| collection | DOAJ |
| description | Abstract Hyperkalemia is a common electrolyte abnormality identified in the emergency department (ED) and potentially fatal. However, there is no consensus over the potassium threshold that warrants intervention or its treatment algorithm. Commonly used medications are at best temporizing measures, and the roles of binders are unclear in the emergent setting. As the prevalence of comorbid conditions altering potassium homeostasis rises, hyperkalemia becomes more common, and hence there is a need to standardize management. A panel was assembled to synthesize the available evidence and identify gaps in knowledge in hyperkalemia treatment in the ED. The panel was composed of 7 medical practitioners, including 5 physicians, a nurse, and a clinical pharmacist with collective expertise in the areas of emergency medicine, nephrology, and hospital medicine. This panel was sponsored by the American College of Emergency Physicians with a goal to create a consensus document for managing acute hyperkalemia. The panel evaluated the evidence on calcium for myocyte stabilization and potassium shifting and excretion. This article summarizes information on available therapies for hyperkalemia and proposes a hyperkalemia treatment algorithm for the ED practitioner based on the currently available literature and highlights diagnostic pitfalls and evidence gaps. |
| format | Article |
| id | doaj-art-c9ff5eaa39794805a521cb537d494939 |
| institution | DOAJ |
| issn | 2688-1152 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-c9ff5eaa39794805a521cb537d4949392025-08-20T03:05:06ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522021-10-0125n/an/a10.1002/emp2.12572Hyperkalemia management in the emergency department: An expert panel consensusZubaid Rafique0Frank Peacock1Terra Armstead2Jason J. Bischof3Joanna Hudson4Matthew R. Weir5James Neuenschwander6Baylor College of Medicine Department of Emergency Medicine Ben Taub General Hospital Houston Texas USABaylor College of Medicine Department of Emergency Medicine Ben Taub General Hospital Houston Texas USAMuskingum University New Concord Ohio USAThe Ohio State University Department of Emergency Medicine Columbus Ohio USAThe University of Tennessee Health Science Center Departments of Clinical Pharmacy and Translational Science & Medicine (Nephrology) Memphis Tennessee USADivision of Nephrology Department of Medicine University of Maryland School of Medicine Baltimore Maryland USAThe Ohio State University Department of Emergency Medicine Columbus Ohio USAAbstract Hyperkalemia is a common electrolyte abnormality identified in the emergency department (ED) and potentially fatal. However, there is no consensus over the potassium threshold that warrants intervention or its treatment algorithm. Commonly used medications are at best temporizing measures, and the roles of binders are unclear in the emergent setting. As the prevalence of comorbid conditions altering potassium homeostasis rises, hyperkalemia becomes more common, and hence there is a need to standardize management. A panel was assembled to synthesize the available evidence and identify gaps in knowledge in hyperkalemia treatment in the ED. The panel was composed of 7 medical practitioners, including 5 physicians, a nurse, and a clinical pharmacist with collective expertise in the areas of emergency medicine, nephrology, and hospital medicine. This panel was sponsored by the American College of Emergency Physicians with a goal to create a consensus document for managing acute hyperkalemia. The panel evaluated the evidence on calcium for myocyte stabilization and potassium shifting and excretion. This article summarizes information on available therapies for hyperkalemia and proposes a hyperkalemia treatment algorithm for the ED practitioner based on the currently available literature and highlights diagnostic pitfalls and evidence gaps.https://doi.org/10.1002/emp2.12572acute managementalgorithmconsensus recommendationhyperkalemia |
| spellingShingle | Zubaid Rafique Frank Peacock Terra Armstead Jason J. Bischof Joanna Hudson Matthew R. Weir James Neuenschwander Hyperkalemia management in the emergency department: An expert panel consensus Journal of the American College of Emergency Physicians Open acute management algorithm consensus recommendation hyperkalemia |
| title | Hyperkalemia management in the emergency department: An expert panel consensus |
| title_full | Hyperkalemia management in the emergency department: An expert panel consensus |
| title_fullStr | Hyperkalemia management in the emergency department: An expert panel consensus |
| title_full_unstemmed | Hyperkalemia management in the emergency department: An expert panel consensus |
| title_short | Hyperkalemia management in the emergency department: An expert panel consensus |
| title_sort | hyperkalemia management in the emergency department an expert panel consensus |
| topic | acute management algorithm consensus recommendation hyperkalemia |
| url | https://doi.org/10.1002/emp2.12572 |
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