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 is given to protect the 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].