Guideline 27.1 – Hyperkalaemia; Algorithm in Cardiac Arrest
We recommend that cardiac arrest attributable to hyperkalaemia is managed using the treatment algorithm which provides guidance on the medical therapies and the need for initiation of renal replacement therapy during CPR. (1C)
Rationale (Guidelines 27.1)
Hyperkalaemia is a potentially reversible cause of cardiac arrest, but achieving and sustaining ROSC is dependent on controlling the serum K+ level. In this way, this special circumstance is analogous to hypothermic cardiac arrest. There are fewer drug therapy options for controlling hyperkalaemia during cardiac arrest (Guidelines 25.1 25.3) and the degree of K+ lowering required to achieve ROSC may not be achievable with drugs alone (Guideline 25.4). The hyperkalaemic cardiac arrest algorithm outlines the modifications to ALS and the specific interventions to address hyperkalaemia as illustrated in Appendix 8.