Resources to support safe and timely management of hyperkalaemia

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A resource alert has been issued to support safe and timely management of hyperkalaemia

Hyperkalaemia is a potentially life threatening emergency that can be corrected with treatment. The following resources offer evidence based guidance to help organisations ensure their clinical staff have easily accessible information to guide prompt investigation, treatment and monitoring options for hyperkalaemia. 

These resources have been posted to assist providers in implementing the actions of the Patient Safety Alert: Resources to support safe and timely management of hyperkalaemia.

Resources for adult patients in hospital

The UK Renal Association guidelines for adults

Clinical practice guidelines treatment of acutehyperkalaemia in adults (2014) is a collaboration between the Renal Association and Resuscitation Council (UK). It was developed to improve the treatment of acute hyperkalaemia and to reduce the risk of complications associated with hyperkalaemia and its treatment.

Additional advice on pre-prepared ‘hyperkalaemia kits’ for adults

Whilst the UK Renal Association guidelines above should be used as the clinical reference in England, the Royal College of Physicians of Edinburgh, and the Guidelines and Audit Implementation Network in Northern Ireland provide additional helpful information on the use of pre-prepared ‘hyperkalaemia kits’.

Resuscitation Council guidelines relating to adults

The UK Resuscitation Council Advanced Life Support guidelines give advice on treating hyperkalaemia during resuscitation and their source guidelines European Resuscitation Council European Resuscitation CouncilGuidelines for Resuscitation 2015 Section 4. Cardiac arrest in special circumstances provide additional detail on causes, recognition and treatment of hyperkalaemia during resuscitation.

NHS Improvement awareness raising video

Our hyperkalaemia awareness raising video for hospital staff provides a short overview of the actions and behaviours that facilitate safe and timely identification, treatment and monitoring of hyperkalaemia. 

Note: If you are not able to view this video because access to YouTube is blocked in your organisation, please email patientsafety.enquiries@nhs.net and request a copy of the video file.

Resources for adult patients in the community

Primary care resources for adults (these may also be helpful to mental health units)

Section 12 of the UK Renal Council’s Clinical practice guidelines treatment of acute hyperkalaemia in adults (2014) is especially relevant to primary care. It recommends that all patients with severe hyperkalaemia (K+ ≥ 6.5 mmol/L) are referred to secondary care for immediate assessment and treatment but that patients with mild (K+ ≥ 5.5-5.9 mmol/L) or moderate (K+ 6.0-6.4 mmol/L) hyperkalaemia have a review of their medication and diet and regular monitoring of serum potassium; the urgency of assessment and frequency of potassium monitoring will depend on individual circumstances. 

NHS Improvement awareness raising video

Primary care services will also find our hyperkalaemia awareness raising video for general practice staff helpful to raise awareness of the need for urgent referral amongst staff groups that may receive or review results of blood tests.

Note: If you are not able to view this video because access to YouTube is blocked in your organisation, please email patientsafety.enquiries@nhs.net and request a copy of the video file.

Resources for babies, children and young people

There is currently no nationally published guidance which relates directly to the management of hyperkalaemia in babies, children or young people but the safety messages of identification, timely treatment and ongoing monitoring are reinforced in the video below and treatment options are outlined in the British National Formulary for Children (BNFC).

NHS Improvement awareness raising video (coming soon)

An awareness raising video providing an overview of the actions and behaviours which facilitate safe and timely identification, treatment and monitoring of hyperkalaemia in babies, children and young people will be posted on this webpage once completed.

The BNF for children

The BNF for children (BNFC) is a clinically validated guide that aims to provide authoritative, independent guidance on best practice, and enable safe medication use in children up to their 18th birthday. The BNFC is intended for use by healthcare professionals, including pharmacists and is a joint publication of the Royal Pharmaceutical Society, the British Medical Association, the Royal College of Paediatrics and Child Health and the Neonatal & Paediatric Pharmacists Group.

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