Paramedic management of out-of-hospital cardiac arrest secondary to hyperkalaemia

Matthew Metcalf
Friday, June 2, 2017

Hyperkalaemia is a potentially life-threatening metabolic emergency and is the most common electrolyte disorder associated with death. The author attended an incident where a patient suffered asystolic cardiac arrest from hyperkalaemia and was subsequently resuscitated successfully to hospital discharge with good neurological outcome. This piece intends to review all relevant available literature with the aim of developing recommendations to aid paramedics in managing cardiac arrest secondary to Hyperkalaemia. Despite the lack of current good-quality evidence for pharmacological interventions, systematic reviews available have led to the development of clear guidelines. The use of calcium chloride and sodium bicarbonate is recommended, and these are both carried by Critical Care Paramedics (CCPs). Salbutamol therapy has the strongest evidence base of any intervention available out of hospital. It should be considered after the use of the aforementioned medications if the patient achieves ROSC. Consideration must also be taken as to whether the patient would benefit from being moved to hospital to reach vital interventions such as insulin/dextrose therapy and dialysis.

Subscribe to get full access to the Journal of Paramedic Practice

Thank you for vising the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.

CPD Focus

Reading the Journal of Paramedic Practice counts towards your professional development

Develop your career

We provide professional information dedicated to paramedics covering training, education and jobs

Stay informed

Get the latest clinical information to ensure you are aware of the latest think and best practice in paramedicne

Subscribe now

Already registered? - Sign in here