Treatment for hypokalaemia

For patients with insulin poisoning, measure the serum potassium concentration every 2 to 4 hours. Replace potassium in patients with hypokalaemia and aim for a serum potassium concentration of more than 3.5 mmol/L.

If the serum potassium concentration is low, but more than 3 mmol/L, and patients can tolerate and absorb oral potassium, use:

potassium chloride 14 to 16 mmol (child: 0.25 mmol/kg up to 16 mmol) orally, every 2 to 4 hours as required to achieve a serum potassium concentration of more than 3.5 mmol/L¹. insulin poisoning potassium chloride

If the serum potassium concentration is less than 3 mmol/L or patients cannot tolerate or absorb oral potassium, use:

potassium chloride 10 to 20 mmol (child: 0.4 mmol/kg up to 20 mmol) intravenously over 1 to 2 hours with ECG monitoring, every 2 to 4 hours as required to achieve a serum potassium concentration of more than 3.5 mmol/L. Use a premixed solution of the appropriate intravenous fluid².

¹ Effervescent immediate-release tablets of potassium contain 14 mmol of potassium per tablet, and modified-release tablets contain 8 mmol of potassium per tablet. The modified-release preparations of potassium are almost completely absorbed within 1 hour.Return

² Potassium chloride should only be given using premixed infusion bags. Extemporaneously adding ampoules of potassium chloride to intravenous fluids is not safe; inadequate mixing may result in potassium being delivered at a lethal concentration. Premixed infusion bags are available in varying concentrations and volumes; the most common is potassium chloride in 1000 mL of compatible fluid. Premixed potassium chloride is also available in a smaller volume at a high concentration (10 mmol/100 mL). Choice of preparation depends on the amount of potassium required and how much fluid the patient will tolerate.Return