Does anyone have info on IV potassium in their clinic?

[Vampgirl143]

I am new to the ambulatory setting but have 11 years of ICU experience. I have been looking for info. on giving IV potassium replacement in the clinic where I work. Currently there is no policy/protocol for the administration of IV replacement. I would like to change this and improve patient care but need to see what other people are doing. Please let me know if you have any information.... good or bad! Any articles you may know of would be wonderful. Thanks.:redpinkhe

[Rookie12]

Patient

Type

Type

of Infusion

Maximum Rate

Site of Infusion

Maximum Concentration (a)

Monitoring Guidelines

Adult Maintenance (non-urgent replenishment) 10 mEq per hour Peripheral 60 mEq / liter serum K+ at least daily; monitor for signs of hyperkalemia(1) 20 mEq per hour Central 100 mEq / liter serum K+ at least daily; ECG monitor; signs and symptoms of hyperkalemia(1) Acute Replacement 10 mEq per hour for serum K+ >3 but = 40 mEq infused; monitor for signs of hyperkalemia(1) 20 mEq per hour for serum K+

20 mEq / 100 mL most commonly seen serum K+ after 40 mEq per hour infused; ECG monitor for rates >=20 mEq per hour; monitor for signs of hyperkalemia(1) 40 mEq per hour for serum K+

20 mEq / 100 mL most commonly seen serum K+ after 40 mEq per hour infused; ECG monitor for rates >=20 mEq per hour; monitor for signs of hyperkalemia(1) 40 mEq per hour Central 40 mEq / 100 mL as above: ECG for rates >=20 mEq per hour or concentration >=40 mEq per 100 mL Pediatric Maintenance (non-urgent replenishment) 0.3 mEq//kg/hr to a maximum of 10 mEq per hour

Peripheral 60 mEq per liter serum K+ at least daily; monitor for signs of hyperkalemia(1) Acute Replacement 0.5 mEq/kg/ dose over 1 hour to a maximum of 20 mEq/hr.

1 mEq/kg/hr may be given to symptomatic pts at discretion of an ATT MD (max 40 mEq/hr) Peripheral 80 mEq per liter serum K+ prior to administration and within 1 hour after infusion completed; ECG monitor for all patients ; monitor for signs of hyperkalemia(1) 1 mEq/kg/hr Central 40 mEq / 100 mL serum K+ prior to administration and within 1 hour after infusion completed; ECG monitor for all patients ; monitor for signs of hyperkalemia(1)

[JordanRose]

I sure wouldn't be doing this without telemetry and crash cart! Sounds like a dangerous situation to me.