Treatment of Electrolyte Deficiency

• Consider cause (including medications) and history of hypokalaemia (acute or chronic?)
• Measure as part of a bundle - calcium, magnesium, potassium and phosphate.
• Consider ECG if patient on cardioactive medication or presenting with palpitations.
• ECG necessary in K+ < 3.0 (acute hypokalaemia)
• Complex hypokalaemic patients need senior discussion - if considering replacing with potassium above 40mmol/L contact consultant on call/HAN team or Dr O’Donnell (daytime).

**NaCl 0.9% or Dextrose 5% with 40mmol KCl in each litre bag are also available

• Normal range is 0.74 -1.52mmol/L
• Not to be prescribed without senior discussion
• Measure as part of a bundle - calcium, magnesium, potassium and phosphate.
• Replacement of phosphates in hypophosphataemia is generally via the IV route

• Normal range (0.75-1.0mmol/L)
• Measure as part of a bundle - calcium, magnesium, potassium and phosphate.
• If hypomagnesaemia occurs with hypocalcaemia and hypokalaemia, magnesium replacement should be via IV route.

* 10mls of Magnesium Sulphate 50% contains 20mmol Magnesium.

• Rarely necessary and only in symptomatic patients (except in arrhythmia and hyperkalaemia) where  Calcium (corrected) < 1.8
• Consider cause of hypocalcaemia
• Measure as part of a bundle - calcium, magnesium, potassium and phosphate.
• Use corrected calcium value (normal range is 2.12-2.62mmol/L)
• Monitoring of ECG & plasma calcium required