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Emergency Medical Minute


Jan 16, 2023

Contributor: Aaron Lessen, MD

Educational Pearls:

  • Hyperkalemia may cause cardiac arrest 
  • Treatment of suspected hyperkalemic cardiac arrest begins with typical management of cardiac arrest including high-quality CPR, defibrillation if appropriate, and resuscitation medications 
    • Administer calcium products to stabilize cardiac membrane and potassium shifting medications 
    • If ROSC is achieved, initiate dialysis 
  • There are several case reports of patients being dialyzed while CPR is ongoing, with some success  
    • Dialysis during resuscitation may be an appropriate treatment for some patients 


Jackson MA, Lodwick R, Hutchinson SG. Hyperkalaemic cardiac arrest successfully treated with peritoneal dialysis. BMJ. 1996;312(7041):1289-1290. doi:10.1136/bmj.312.7041.1289

Kao KC, Huang CC, Tsai YH, Lin MC, Tsao TC. Hyperkalemic cardiac arrest successfully reversed by hemodialysis during cardiopulmonary resuscitation: case report. Chang Gung Med J. 2000;23(9):555-559.

Torrecilla C, de la Serna JL. Hyperkalemic cardiac arrest, prolonged heart massage and simultaneous hemodialysis. Intensive Care Med. 1989;15(5):325-326. doi:10.1007/BF00263870

Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD


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