Hyperkalaemia

Hyperkalaemia is a life-threatening complication owing to the risk of cardiac dysrhythmias, particularly ventricular fibrillation. Correction of acidosis with intravenous sodium bicarbonate will also reduce serum potassium concentration, but administration of sodium may be inappropriate if the patient is salt- and water-overloaded.

Rapid correction of acidosis in a hypocalcaemic patient may also trigger tetany, since hydrogen ions displace calcium from albumin-binding sites, thus increasing the physiologically active calcium concentration in blood.

Ion exchange resins are used to prevent subsequent hyperkalaemia rather than to deal with the acute emergency. In many patients, hyperkalaemia will be controlled only by dialysis or haemofiltration.

Severe hyperkalaemia is rarely a direct complication of acute poisoning. Most commonly it develops secondary to complications of the poisoning especially rhabdomyolysis, acute renal failure and metabolic acidosis.

In patients with renal insufficiency or hyperkalaemia, emergency room physicians could not reliably detect or exclude hyperkalaemia nor grade its severity from the ECG alone.

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Health Tip

Running and jogging are excellent aerobic activities but it is essential to wear proper foot wear to prevent heal damage and avoid making hip and back problem worse.