Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/29931
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dc.contributor.authorPollack, Kimberley-
dc.contributor.authorManning, Kiri R-
dc.contributor.authorBalassone, Jacqueline-
dc.contributor.authorBui, Calista-
dc.contributor.authorTaylor, David McD-
dc.contributor.authorTaylor, Simone E-
dc.date2022-
dc.date.accessioned2022-06-22T06:40:49Z-
dc.date.available2022-06-22T06:40:49Z-
dc.date.issued2022-04-11-
dc.identifier.citationEmergency Medicine Australasia : EMA 2022; 34(5): 751-757en
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/29931-
dc.description.abstractTo describe the epidemiology, treatment and monitoring of treatment outcomes of patients presenting to the ED with hyperkalaemia. We undertook a retrospective observational study in a mixed adult/paediatric ED over five 3-month periods. Consecutive patients were included if they had an initial serum or blood gas potassium ≥6.0 mmol/L. Patients were excluded if their principal diagnosis was diabetic ketoacidosis, their blood sample was haemolysed or the blood gas result was inconsistent with a subsequent serum potassium. Data were extracted from electronic medical records and two senior emergency registrars independently assessed available ECGs. Moderate and severe hyperkalaemia were potassium 6.0-6.4 and ≥6.5 mmol/L, respectively. Overall, 392 patients were included (mean age 73.7 years, triage category 1 or 2 28.3%, admitted 91.3%). Three hundred and twenty-one (81.9%, 95% confidence interval [CI] 77.6-85.5%) patients took one or more medications that predispose to hyperkalaemia and 335 (85.5%, 95% CI 81.5-88.7%) had one or more predisposing comorbidities. Two hundred and seventy-one (69.1%, 95% CI 64.3-73.6%) patients had moderately severe and 121 (30.9%, 95% CI 26.4-35.7%) had severe hyperkalaemia. Two hundred and fifty-nine (66.1%, 95% CI 61.1-70.7%) patients were administered at least one medication in ED to lower the potassium concentration and 51 (13.0%, 95% CI 9.9-16.8%) were dialysed. One hundred and eighty-seven patients received intravenous insulin: 40 (21.4%) had documented biochemical hypoglycaemia, but 45 (24.1%) had no post-insulin blood glucose level documented. Hyperkalaemia-associated ECG changes were uncommon. Most ED patients with hyperkalaemia have identifiable clinical and medication-related risk factors. Variations in care were widespread and monitoring for iatrogenic adverse events was suboptimal.en
dc.language.isoeng-
dc.subjectemergency serviceen
dc.subjecthospitalen
dc.subjecthyperkalaemia/drug therapyen
dc.subjectinsulinen
dc.subjectpotassiumen
dc.titleHyperkalaemia in the emergency department: Epidemiology, management and monitoring of treatment outcomes.en
dc.typeJournal Articleen
dc.identifier.journaltitleEmergency Medicine Australasia : EMAen
dc.identifier.affiliationPharmacyen
dc.identifier.affiliationEmergencyen
dc.identifier.affiliationDepartment of Medicine, The University of Melbourne, Melbourne, Victoria, Australiaen
dc.identifier.affiliationMiddlemore Hospital, Auckland, New Zealanden
dc.identifier.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/35411698/en
dc.identifier.doi10.1111/1742-6723.13971en
dc.type.contentTexten
dc.identifier.orcidhttps://orcid.org/0000-0002-8986-9997en
dc.identifier.orcidhttps://orcid.org/0000-0002-0592-518Xen
dc.identifier.pubmedid35411698-
local.name.researcherTaylor, David McD
item.languageiso639-1en-
item.cerifentitytypePublications-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.grantfulltextnone-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
crisitem.author.deptEmergency-
crisitem.author.deptPharmacy-
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