Please note: this guideline has exceeded its review date and is currently under review by specialists. Exercise caution in the use of the clinical guideline. A partial update to the guideline was made in July 2023 to align with the NPSA alert regarding the dosing and administration of calcium gluconate.
Calcium Resonium® oral 15g three times daily (in water not fruit juice).
Confirmed plasma K+ >6.5mmol/L and/or ECG changes (although treatment should not be delayed, result should be confirmed):
30ml calcium gluconate 10% – IV bolus injection over 10 minutes given by a doctor (to antagonise the effect of potassium on the heart).
8units soluble insulin (Actrapid®) in 100ml IV glucose 20% vial over 30 minutes (to move potassium into the cells). This may be repeated once and/or followed by an infusion of the same mixture at 5–10ml/hour.
5–10mg nebulised salbutamol.
Content last reviewed October 2018