Background: Hyperkalemia is the most common electrolyte disorder seen in the Emergency Department and treatment of hyperkalemia is core knowledge of EM training for interns and focuses on:
1) Stabilization of cardiac myocytes with calcium salts2) Temporary shifting of potassium into cells (insulin, beta agonists, normal saline,magnesium, sodium bicarbonate)3) Removal of potassium from the body (i.e. loop diuretics, cathartics)4) Definitive Treatment (i.e. Hemodyalisis)
Although there is still some debate on the first two areas (i.e. is there truly a role for sodium bicarbonate?) our focus will be on the removal part of the algorithm, specifically, is there a role for kayexalate?