Hyperkalaemia needs to be treated in a safe and timely way

There have been 35 reports of patients suffering cardiac arrest while hyperkalaemic.

James McKay
9 August 2018

NHSI has issued a patient safety alert over the treatment of hyperkalaemia.

NHS Improvement has issued a patient safety alert over the management of hyperkalaemia, warning healthcare staff that it should be treated in both a safe and timely way.


Over a recent three-year period, the National Reporting and Learning System has received 35 reports of patients suffering cardiac arrest while hyperkalaemic. Which NHSI says may indicate some health care professionals may not appreciate that clinical assessment, treatment and ongoing monitoring of hyperkalaemia is time critical.

Typical extracts from incident reports read:

  • “the patient had a raised potassium which required treatment and [a member of staff] apparently stated that the day team could deal with it.”
  • “[Treatment for hyperkalaemia] was prescribed and administered at approx 16:30; however, no further review of the patient was undertaken and no repeat treatment or bloods were done until the patient arrested at 09:26.”

Severe hyperkalaemia is a potentially life-threatening emergency which can be corrected with treatment.


According to the UK Renal Council’s guidelines on the treatment of hyperkalaemia, there is no universal definition of hyperlalaemia, but a serum K+ ≥ 5.5 mmol/L is widely used.

Potassium is essential for the body’s normal function, including maintenance of normal heart rhythm. The way the body responds to hyperkalaemia – a higher than normal level of potassium in the blood – is unpredictable; arrhythmias and cardiac arrest can occur without warning. Hyperkalaemia can affect patients in hospital as well as those being cared for at home.

Healthcare staff should contact their trust pharmacist or medicines management team for specific information and protocols for the treatment of hyperkalaemia.

NHSI has created a resource dedicated for organisations to support safe and timely management of hyperkalaemia.


Inline Feedbacks
View all comments