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Updated: Oct 25, 2025

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Fifteen-minute consultation: Emergency management of children presenting with hyperkalaemia

Matthew Rubens1, Constantinos Kanaris2,3

  • 1Department of Paediatrics, North Middlesex University Hospital, London, UK.

Archives of Disease in Childhood. Education and Practice Edition
|August 4, 2021
PubMed

Insights

Hyperkalaemia, a condition of high potassium, can cause dangerous heart rhythms. Effective management involves preventing arrhythmias, shifting potassium into cells, and reducing overall body potassium, with careful fluid choices potentially improving outcomes.

Area of Science:

  • Nephrology
  • Internal Medicine
  • Cardiology

Background:

  • Hyperkalaemia presents a significant risk for life-threatening cardiac arrhythmias.
  • Understanding the underlying physiology is crucial for effective management.
  • Current management strategies aim to stabilize cardiac function, redistribute potassium, and eliminate excess potassium from the body.

Purpose of the Study:

  • To review the physiological basis of hyperkalaemia management.
  • To outline rational and effective treatment strategies.
  • To discuss the role of fluid management in hyperkalaemia.

Main Methods:

  • Review of physiological principles of potassium homeostasis.
  • Analysis of established and emerging treatment modalities for hyperkalaemia.
  • Evaluation of fluid management strategies, including balanced solutions versus 0.9% saline.

Main Results:

  • Management priorities include preventing arrhythmias, promoting intracellular potassium shift, and reducing total body potassium.
  • Balanced crystalloid solutions may offer theoretical advantages over 0.9% saline in managing hyperkalaemia.
  • Careful consideration of fluid type and volume is essential.

Conclusions:

  • A thorough physiological understanding guides efficient hyperkalaemia treatment.
  • Multi-faceted management approach is necessary to address immediate risks and long-term potassium balance.
  • Optimizing fluid management is an important consideration in the comprehensive care of hyperkalaemia.

Keywords:
biochemistrynephrologypharmacologyphysiologyresuscitation

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