Potassium Superlatives

I saw a 13 when I was doing an internship in renal. Patient tried to commit suicide by skipping dialysis and drinking tons of orange juice. She almost "succeeded."

11.8 in a diabetic patient whose one remaining foot was gangrenous. She was a nursing home "dump" with end-stage dementia. I remember it because the interns and residents were so excited about it that they blew off the patient next door who was an elderly man living independantly who was perforating an ulcer at the same time. She lived - for a while - in CCU ... he died the next day.

I think the highest was a 6.5 or 7. The lowest was a 1.8 and all kinds of dysrhythmias. We opened up 3 20meq bags and gave him 60meq in 30 minutes (I can't believe pharmacy allowed this ) and his potassium the next day was 7 and he needed dialysis. I told them they were replacing this too fast, but no one would listen to me. Eventually this pt came off dialysis and was fine. I really thought he would die that night.

Highest I've seen on my floor (tele, not step-down or ICU) was 7.3, lowest was 1.7.

Our ED can be notorious for not initiating treatment...neither one of these patients had anything done regarding their K levels before they hit the floor. Both of them I got "Well, their heart is doing some funny stuff" in report...ya think?