Concentrated Potassium Intravenous infusion - Cardiac Adult Critical Care Only

• Aims
• Background and indications for standard operating procedure/protocol
• Procedure method (step by step)
• Algorithms
• SOP for Assessment, Prescribing, Administration and monitoring of Concentrated Potassium Infusion on Adult Cardiac Critical Care - June 2018

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

• LTHT Medusa 
• LTHT Medicine Code  http://lthweb.leedsth.nhs.uk/sites/medicines-management-and-pharmacy/information-on-medicines/dat/medicines-guidance-and-policies/medicines-code/MEDICINES%20CODE%20v3%2016%20Feb%202011%20-%20Final.pdf
• LTHT Injectable Code http://lthweb.leedsth.nhs.uk/sites/medicines-management-and-pharmacy/information-on-medicines/dat/medicines-guidance-and-policies/Injectable%20Medicines%20Code.pdf
• LTHT Policy on Concentrated Potassium Injection http://thehub.leedsth.nhs.uk/Documents/_layouts/OSSSearchResults.aspx?k=potassium&cs=This%20Site&u=http%3A%2F%2Fthehub.leedsth.nhs.uk%2FDocuments

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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.