Hyperkalemia. Goals of care.

Patient arrives to ED providing history of confusion and weakness. Wife reports this is how he always presents when fighting pneumonia or UTI. Initial ECG is abnormal. Patient is found to have severe acute hyperkalemia requiring calcium, Lasix, glucose and insulin. Patient has AKI with resultant fluid overload and does not tolerate bicarbonate infusion well due to volume status. Patient will either need dialysis or non-invasive positive pressure ventilation but MOST status challenges this.

Goals and Objectives

Educational Goal

• Develop an approach to management of hyperkalemia.

Objectives (Medical and CRM)

• Initial stabilization of acute hyperkalemia.
• Discussion with patient/family regarding level of intervention for frail elderly patient with acute reversible pathology that requires high level of care.