Concentrated Potassium Intravenous infusion in Cardiac Adult Critical Care

Publication: 18/08/2016  
Next review: 25/05/2024  
Standard Operating Procedure
CURRENT 
ID: 4719 
Approved By:  
Copyright© Leeds Teaching Hospitals NHS Trust 2021  

 

This Standard Operating Procedure is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

Concentrated Potassium Intravenous infusion - Cardiac Adult Critical Care Only

Aims

To standardise and optimise the prescription and administration of Concentrated Potassium Intravenous (CPI) infusion in Cardiac Adult critical Care.

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Background and indications for standard operating procedure/protocol

Concentrated potassium infusions within LTHT are those that contain 0.4mmol/ml or more, of potassium.

Concentrated potassium infusions are frequently used in Adult Cardiac Critical Care.

ACC is a designated clinical area for this type of medication administration.

This SOP is used for patients assessed as needing this prescribed treatment as part of the care and treatment during a stay on Adult Cardiac Critical Care.

Concentrated potassium is managed under the Controlled Drug Policy on ACC.

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Procedure method (step by step)

CPI is only to be used when alternative, less risky, methods of administering potassium have been excluded. i.e. Enteral supplements, addition to maintenance fluids.

Concentrated Potassium Infusion must only be administered via a Central Venous Catheter (CVC) and a dedicated Infusion pump

Pharmacy provides ready-to-administer prepared syringes of concentrated potassium chloride. (50mmol in 50mls Sodium Chloride 0.9%)

Standard medication checking procedures must be followed as per the current LTH Medicine Policy and Code at all times.

All prescriptions for intravenous potassium must state the molar dose of potassium chloride, the diluent and volume, duration and /or rate of administration and the route. The target potassium blood concentration range must be specified.

Ensure the correct concentration and potassium dosage is selected on the cardiac section of the infusion pump drug library.

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Algorithms

Refer to -  SOP for Assessment, Prescribing, Administration and monitoring of Concentrated Potassium Infusion on Adult Cardiac Critical Care

Refer to - Potassium Replacement Prescription for Cardiac intensive Care at LGI  - ref WPG621

Evidence Base:   

References

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SOP for Assessment, Prescribing, Administration and monitoring of Concentrated Potassium Infusion on Adult Cardiac Critical Care - June 2018

Each patient must be assessed as to the specific needs for this high risk infusion.

Following each assessment or review the rate of administration is determined by the tested serum potassium level on a blood gas analyser.

 

Serum Potassium
Less than
3.0 mmol/l

Serum Potassium
Between
3.0-3.49 mmol/l

Serum Potassium
Between
3.5-3.99 mmol/l

Serum Potassium
Between
4.0-4.49 mmol/l

Serum Potassium
Between
4.5-4.99 mmol/l

Serum Potassium
At or over
5.1-5.5 mmol/l

Serum Potassium
over
5.5 mmol/l

Assess

 

Ensure medical staff are aware

Ensure medical staff are aware

If unsure ask for advice

If unsure ask for advice

If unsure ask for advice

Ensure medical staff are aware

Ensure medical staff are aware

Prescribe

20mmols

20mmols

20mmols

20mmols

10mmols

 

 

Administer

Give over 20minutes

At VTBI of 20mls

At
Rate of 60mls /hr  

Give over 20minutes

At VTBI of 20mls

At
Rate of 60mls /hr

Give  over 30minutes

At VTBI of 20mls

At
Rate of 40mls /hr

Give  over 40minutes

At VTBI of 20mls

At
Rate of 30mls /hr

Give  over one hour

At VTBI of 10mls

At
Rate of 10mls /hr

TURN any infusion of Potassium OFF

TURN any infusion of Potassium OFF

Monitor

Check Serum potassium
20 minutes after administration

Patients with large urinary output may need more frequent monitoring

Check Serum potassium 30 minutes after administration

Patients with large urinary output may need more frequent monitoring

Check Serum potassium one hour  after administration

Patients with large urinary output may need more frequent monitoring

Check Serum potassium two hours  after administration

Check Serum potassium two hours  after administration

Recheck Serum after 2 hours

Recheck Serum after 1 hour

Provenance

Record: 4719
Objective:
Clinical condition:
Target patient group:
Target professional group(s): Secondary Care Nurses
Secondary Care Doctors
Pharmacists
Adapted from:

Evidence base

Not supplied

Document history

LHP version 1.0

Related information

Not supplied

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