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Discussion

Potassium Rates

I tried going through previous threads about this but none answered my specific question. I had a patient last night that required three 10meq's in 100ml to run in 60 minutes back to back. So since it is in a pump that would be 100ml/hr correct? I decided to slow it down and run it at 80ml and that was one hour and fifteen minutes. The pt stayed in normal sinus rhythm and his heart rate was anywhere between 70-75 the whole time. When he woke up his vitals were HR 75 BP 134/60 something. I also piggybacked it with IV fluid that ran at 84ml /hr. There were no specific orders that said to run it a certain number other than over 60 minutes. Now my question is, did I run it too fast or was that an appropriate rate? When I went through the previous threads there was nothing clear about that. He said it never burned and he didn't even feel it and it went in a central line. Thank you in advance!

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    So you ran 3 separate 100ml bags, containing 10meqs each, over a total of 3 hours and 45 minutes? If so, sounds ok to me. Typically the max IV dose of K+ is 10meqs per hour.

    A little slower shouldn't hurt. K+ infusions are frequently slowed down because of vein irritation. But never give it too fast.

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    I think the max is 20mEq per hour when on telemetry so you're good.

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    10 mEq K+/hr (you can ask the doc for a vial of Neut, which takes the burn out completely, its 5 mL added to 10 mEq, you are adding 5mL of sodium bicarb to raise the pH of the K+ bag).

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    • Author

    But was running the regular IV fluid with it at 84 wrong? This was a discussion I had with someone.

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    If you truly piggybacked it into the 84 mL/hr fluids (as opposed to Y-site below the IV pump) then the 84 mL fluid is not infusing, just the K.

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    There is typically a protocol that says not to run K+ at a rate greater than 10mEq/hr. There isn't really any "minimum" at which you should run it unless an order specifies over a period of time. Typically, I run mini-bags over an hour, but if my patient is expressing irritation at the IV site, I slow the rate and consult with the physician to explain why I changed the rate. I've rarely had one argue with me, especially if the patient is a difficult stick and prone to losing IV access.

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    K+ can run at 10 mEq/hr. In my facility you can't piggyback electrolytes. They have to run them with fluids at the y-site. If it's running in a central line the patient won't feel it.

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    K+ can run at 10 mEq/hr. In my facility you can't piggyback electrolytes. They have to run them with fluids at the y-site. If it's running in a central line the patient won't feel it.

    At our hospital, K can run at 20 meq/hr through a central line…FWIW. To the OP--check the facility policy.

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    10 mEq K+/hr (you can ask the doc for a vial of Neut, which takes the burn out completely, its 5 mL added to 10 mEq, you are adding 5mL of sodium bicarb to raise the pH of the K+ bag).

    What is neut. I have never heard of it. Thanks, Maggie

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    What is neut. I have never heard of it. Thanks, Maggie

    It's the trade name for a 4% sodium bicarbonate solution.

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    At our hospital, K can run at 20 meq/hr through a central line...FWIW. To the OP--check the facility policy.

    It can here also but the patient has to be on telemetry.

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