Lightning Learning: Hyperkalaemia

Lightning Learning: Hyperkalaemia

“Don’t be caught off guard by Hyperkalaemia as it can present in many ways. Be aware of patients with diabetes, AKI or cardiac issues!”
— advice is based on local guidelines & procedures


Hyper K+ = >5.5mmol/l

>5.5: Repolarisation abnormalities – the classical “Tented T-Wave”

>6.5: Paralysis of the atria – flattened p-waves & prolonged PR Segment

>7.0: Conduction abnormalities & bradycardia the ECG can be bizarre including…

  • AV blocks

  • Junctional Rhythms

  • Bundle Branch or Fascicular Blocks

  • Sinus Brady or Slow AF

Sine Waves are pre-terminal!


Hyperkalaemia is one of the 8 reversible causes of cardiac arrest, however we should identify and treat our patients before this happens.

All patients with hyperkalaemia need an ECG and if it is abnormal treatment should be started immediately, give calcium gluconate.

Remember to also think hyperkalaemia in any bradycardic patient.


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