Electrolyte Replacement

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ADULT ELECTROLYTE REPLACEMENT PROTOCOLS
Standing electrolyte replacement protocols are available for use in adult patients admitted to King Khaled Hospital. Najran, Saudi Arabia.
The protocols are listed below.
SPECIFIC REQUIREMENTS:
• Intravenous infusions of electrolytes must be administered with free-flow protected infusion devices (i.e. infusion pump).
• Patients must meet the following criteria prior to initiation of the Potassium, Magnesium, or
Phosphorus protocols: o SCr < 2 mg/dL o Weight > 40 kg
• The electrolyte replacement protocols, Calcium chloride (Level I areas only) or Calcium gluconate (all levels of care), Magnesium sulfate, Potassium chloride, or Potassium Phosphate, may be ordered individually or in combination.
POTASSIUM REPLACEMENT PROTOCOL – INTRAVENOUS
• Recommended rate of infusion is 10 mEq/h
• Maximum rate of intravenous replacement is 20 mEq/h with continuous ECG monitoring (the maximum rate may be increased to 40 mEq/h in emergency situations)
• Standard Concentrations: 10 mEq/50 mL, 10 mEq/100mL, 20 mEq/50 mL and 20 mEq/100 mL o Maximum Concentration for Central IV administration = 20 mEq/50 mL o Maximum Concentration for Peripheral IV administration = 10 mEq/50 mL
|Current Serum Potassium Level |Central IV Administration |Peripheral IV Administration |Monitoring |
|3.6 – 3.9 mEq/L |20 mEq IV over 2 HR x 1 |10 mEq IV over 1 HR x 2 |No additional action |
|3.4 – 3.5 mEq/L |20 mEq IV over 2 HR x 1 |10 mEq IV over 1 HR x 3 |No additional action |
| |AND | | |
| |10 mEq IV over 1 HR x 1 | | |
|3.1 – 3.3 mEq/L |20 mEq IV over 2 HR x 2 |10 mEq IV over 1 HR x 4 |Recheck serum

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