IV calcium gluconate should be given without delay in hyperkalaemia
Dose: 10ml of 10% calcium gluconate by slow IV injection over 2 minutes (ECG monitoring recommended).
This has a stabilising effect on the myocardium but no effect on serum potassium concentration. Rhythm abnormalities usually reverse immediately following administration of calcium. If necessary the dose may be repeated after about 5 minutes until an improvement in ECG is seen.
Use of IV calcium is generally not advised in patients on digoxin as this may precipitate cardiac arrhythmias in patients receiving digoxin. If calcium is given it should not be given rapidly or in large amounts in order to avoid high serum calcium concentrations.
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