What is the acute treatment for life threatening hyperkalemia?
Calcium gluconate or calcium chloride, 10% solution, 10 mL IV over 10 minutes can help antagonize the membrane effects of hyperkalemia on the myocardial conducting system. This effect lasts for 30 to 60 minutes. Calcium chloride is preferred in patients with cardiac arrest due to hyperkalemia because it releases active calcium immediately upon infusion, unlike calcium gluconate, which requires hepatic metabolism to release calcium. Calcium gluconate can be administered IV via a peripheral vein but calcium chloride requires a central line because extravasation can cause tissue necrosis.
