Trigger
- K >= 6.0 mmol/L or ECG changes
- Rapid rise in K with AKI/oliguria
Stabilize
- Calcium gluconate (cardiac membrane)
- Continuous ECG monitoring
Shift K
- Insulin + glucose
- Bicarbonate if acidotic
- Beta-agonist if appropriate
Remove K
- Loop diuretic if producing urine
- Resin binder as adjunct
- Dialysis if refractory or severe
Reassess
- Repeat K and ECG in 1-2 hours
- Identify and stop K sources
Educational reference only. Not a substitute for clinical guidelines or supervision.