Hypokalaemia

In hypokalaemia, hypomagnesemia should be excluded and treated first if present before potassium replacement

• Hypomagnesemia commonly coexists with hypokalemia and can impair potassium reabsorption in the kidney
• Failure to correct magnesium deficiency can result in persistent or refractory hypokalemia despite potassium supplementation

Only use ready-made diluted

0.9% sodium chloride (normal saline) is the standard diluent used in premade intravenous potassium chloride bags.

potassium solution, NEVER add further potassium into a pre-made bag.

Precautions with peripheral IV potassium use:

• Maximum infusion rate WITHOUT cardiac monitoring is 10 mmol/hr
• Maximum infusion rate WITH cardiac monitoring is 20 mmol/hr
• Maximum K+ concentration of 40 mmol/L

Central venous access is necessary if the rate >20 mmol/hr (due to risk of arrhythmias/cardiotoxicity) or if the concentration is >40 mmol/L (as these concentrations are phlebitic).