Adult Hyperkalaemia Management

Clinical Guideline

V5.0

September 2019
Summary

Adult Hyperkalaemia Management Clinical Guideline V5.0

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1. Aim/Purpose of this Guideline
1.1. This guideline has been written to inform all doctors caring for adults and
provides a written reference to guide the management of hyperkalaemia in adults.

1.2. This version supersedes any previous versions of this document.

1.3. Data Protection Act 2018 (General Data Protection Regulation –

GDPR) Legislation

The Trust has a duty under the DPA18 to ensure that there is a valid legal basis
to process personal and sensitive data. The legal basis for processing must be
identified and documented before the processing begins. In many cases we may
need consent; this must be explicit, informed and documented. We can’t rely on
Opt out, it must be Opt in.

DPA18 is applicable to all staff; this includes those working as contractors and
providers of services.

For more information about your obligations under the DPA18 please see the
‘information use framework policy’, or contact the Information Governance Team
rch-tr.infogov@nhs.net

2. The Guidance
See Summary for flow chart

3. Monitoring compliance and effectiveness

Element to be The management of Acute Kidney Injury (AKI) is monitored and
monitored audited. Hyperkalaemia often accompanies AKI.

Lead Dr Steve Dickinson is the Clinical Lead, and Dr Jon Stratton is the
lead for Clinical Governance in the Renal Department.

Tool Use of the hyperkalaemia guideline is not currently audited.

Frequency Annually
Reporting Through the Renal management meeting (meets fortnightly)
arrangements
Acting on The renal team are open to all feedback received from any source
recommendations on these guidelines
and Lead(s)
Change in Any required changes in practice that are identified will lead to an
practice and amendment of the guideline. Any lessons to be shared will be shared
lessons to be in the appropriate arena e.g. presenting at the Grand Round.
shared

Adult Hyperkalaemia Management Clinical Guideline V5.0

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4. Equality and Diversity
4.1. This document complies with the Royal Cornwall Hospitals NHS Trust
service Equality and Diversity statement which can be found in the 'Equality,
Inclusion & Human Rights Policy' or the Equality and Diversity website.

4.2. Equality Impact Assessment

The Initial Equality Impact Assessment Screening Form is at Appendix 2.

Adult Hyperkalaemia Management Clinical Guideline V5.0

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Appendix 1. Governance Information
Adult Hyperkalaemia Management Clinical
Document Title
Guideline V5.0

Date Issued/Approved: 11th September 2019

Date Valid From: September 2019

Date Valid To: September 2022

Directorate / Department responsible

Dr Steve Dickinson, Renal Consultant
(author/owner):

Contact details: 01872 253241

Brief summary of contents Adult Hyperkalaemia Management

Guideline
Hyperkalaemia - Emergency treatment -
Potassium - Metabolic disorders - Water
Suggested Keywords: balance disorders - Water electrolyte
imbalance - Hyperkalaemia - Adults -
Prescribing - Medicines management -
Drug therapy
RCHT CFT KCCG
Target Audience

Executive Director responsible for
Medical Director
Policy:
Date revised: 11th September 2019
This document replaces (exact title of Clinical Guideline For Adult
previous version): Hyperkalaemia Management V4.0
Approval route (names of Renal Consultants through Renal
committees)/consultation: Governance Meeting

Care Group General Manager

Sidwell Lawler
confirming approval processes
Name and Post Title of additional
Not Required
signatories

Name and Signature of Care {Original Copy Signed}

Group/Directorate Governance Lead
confirming approval by specialty and
care group management meetings Name: Becky Osborne

Signature of Executive Director giving {Original Copy Signed}

approval

Adult Hyperkalaemia Management Clinical Guideline V5.0

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 Publication Location (refer to Policy
on Policies – Approvals and Internet & Intranet  Intranet Only
Ratification):
Document Library Folder/Sub Folder Clinical / Renal
Renal Association and Resuscitation
Links to key external standards
Council UK joint guidelines 2014
Related Documents: Acute Kidney Injury Guideline
Training Need Identified? No

Version Control Table

Version Changes Made by

Date Summary of Changes
No (Name and Job Title)
March
V1.0 Adult Hyperkalaemia Management guideline Renal Consultants
2006
Adult Hyperkalaemia Management guideline Dr Steve Dickinson
07.10.10 V2.0
revised Renal Consultant

Dr Steve Dickinson
06.08.13 V3.0 Adult Hyperkalaemia Management guideline,
Renal Consultant
no changes made
Andrew Rogers,
23/06/14 V3.1 Addition of mobile summary as appendix 1
Corporate Records

Adult Hyperkalaemia Management guideline-

updated in light of new Renal Association and
Resuscitation Council UK joint guidelines
2014 i.e.
1. In the cardiac stabilizer section, 30mls
Calcium Gluconate is now recommended
and has been adopted in these Dr Steve Dickinson
14/07/16 V4.0
guidelines. Renal Consultant
2. In the intracellular shift section, the use
of salbutamol nebulisers is now
recommended and has been adopted.
3. When patients are already taking
digoxin, give calcium gluconate over 30 mins
rather than 20 mins- see guideline.

11th No changes made, as no new national

guidance since the previous review. Moved to Dr Steve Dickinson
September V5.0
latest Trust template. Renal Consultant
2019

All or part of this document can be released under the Freedom of Information
Act 2000

This document is to be retained for 10 years from the date of expiry.

This document is only valid on the day of printing
Adult Hyperkalaemia Management Clinical Guideline V5.0
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 Controlled Document
This document has been created following the Royal Cornwall Hospitals NHS Trust
Policy for the Development and Management of Knowledge, Procedural and Web
Documents (The Policy on Policies). It should not be altered in any way without the
express permission of the author or their Line Manager.

Adult Hyperkalaemia Management Clinical Guideline V5.0

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Appendix 2. Initial Equality Impact Assessment Form
Name of the strategy / policy /proposal / service function to be assessed

Adult Hyperkalaemia Management Clinical Guideline V5.0

Directorate and service area: New or existing document:

Renal Existing

Name of individual completing assessment: Telephone:

Dr Steve Dickinson 01872 253241

1. Policy Aim* To provide a written reference to guide the management of

hyperkalaemia in adults.
Who is the strategy /
policy / proposal /
service function aimed
at?
2. Policy Objectives* To provide a written reference to guide the management of
hyperkalaemia in adults.

3. Policy – intended
Outcomes* Appropriate management of hyperkalaemia in adults.

4. *How will you

measure the We will listen to feedback from all areas on this guideline
outcome?
5. Who is intended to
benefit from the Adult patients
policy?
6a Who did you Local External
Workforce Patients Other
consult with groups organisations
X

b). Please identify the Please record specific names of groups

groups who have
been consulted about All renal consultants at RCHT and Dr Jain, Renal Registrar
this procedure.
What was the
outcome of the Agreed
consultation?

7. The Impact
Please complete the following table. If you are unsure/don’t know if there is a negative
impact you need to repeat the consultation step.

Are there concerns that the policy could have differential impact on:
Equality Strands: Yes No Unsure Rationale for Assessment / Existing Evidence
Adult Hyperkalaemia Management Clinical Guideline V5.0
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Age X
X
Sex (male,
female, trans-gender /
gender reassignment)

Race / Ethnic X
communities
/groups
Disability - X
Learning disability,
physical
impairment, sensory
impairment, mental
health conditions and
some long term health
conditions.
Religion / X
other beliefs
Marriage and X
Civil partnership
Pregnancy and X
maternity
Sexual X
Orientation,
Bisexual, Gay,
heterosexual, Lesbian
You will need to continue to a full Equality Impact Assessment if the following have
been highlighted:
 You have ticked “Yes” in any column above and

 No consultation or evidence of there being consultation- this excludes any policies which have
been identified as not requiring consultation. or

 Major this relates to service redesign or development

8. Please indicate if a full equality analysis is recommended. Yes No X

9. If you are not recommending a Full Impact assessment please explain why.

No negative impact, consultation has taken place and no major redesign/development

required.

Policy Review Group

Members approving
Date of completion and th (PRG)
11 September 2019 screening assessment
submission
APPROVED

This EIA will not be uploaded to the Trust website without the approval of the Policy
Review Group.

A summary of the results will be published on the Trust’s web site.

Adult Hyperkalaemia Management Clinical Guideline V5.0

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