A 28 yo drug user presents to the ED with collapse and anuria. His serum K+ = 7.5mmol/L. CXR =
early pulmonary edema. What is the next appropriate management?
a. Urgent hemodialysis
b. IV calcium gluconate
c. IV insulin + dextrose
d. Furosemide
e. IV NS 0.9%
Ans. The key is B. IV calcium gluconate. [IV calcium gluconate isgiven to ]. Protectthe heart from lethal arrhythmia or cardiac arrest from high potassium level and used to buy time while definitive management is being taken. Actually calcium gluconate don’t lower the potassium level that much but protect the heart from arrhythmia].