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Fifteen-minute consultation: Emergency management of children presenting with hyperkalaemia
  1. Matthew Rubens1,
  2. Constantinos Kanaris2,3
  1. 1 Department of Paediatrics, North Middlesex University Hospital, London, UK
  2. 2 Paediatric Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  3. 3 Blizard Institute, Queen Mary University of London, London, UK
  1. Correspondence to Dr Constantinos Kanaris, Paediatric Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK; ckanaris{at}


Hyperkalaemia can lead to life-threatening cardiac arrhythmias. A good understanding of the physiological basis of management can help us rationalise treatment and reduce plasma potassium levels efficiently and effectively. Management focuses on avoidance of arrythmias, rapid intracellular movement of potassium and finally reduction of total body potassium. Fluid management in hyperkalaemia should be carefully considered, with balanced solutions providing theoretical benefits compared to 0.9% saline in certain situations.

  • nephrology
  • biochemistry
  • physiology
  • pharmacology
  • resuscitation

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  • Contributors MR and CK contributed equally to this work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Author note Lyla is a fictitious patient and the case has been created to help the reader think and apply the evidence portrayed in the paper as if it were a real scenario.