MI Queries

[Woody]

I'm dealing with some medicines information queries for an assignment at the moment, I understand I cant just expect answers to my questions but any guidance in the right direction would be very helpful, I've just spent all afternoon with not much luck so far!
At first I thought the question was easy, but filling it out into a meaningful response is proving difficult.

A hospital doctor phones MI and would like to administer potassium chloride IV for a patient with heart failure.
What rate of administration should she use?
Can she administer IV potassium undiluted for a 'quick return to normal serum potassium level', Give an explanation.

[bleepholder]

NPSA have released safety alerts regarding use of intravenous potassium (few years abck now i think).....not sure who easy it is to search on their site???

assuming you work in a hospital.....they are liekly to have potassium guidelines...

[johnep]

Standard 'catch you out' question. Many people have died from potassium chloride injections of the wrong strength. There was a move to ensure that strong solutions should never be supplied to a ward. Similarly for sodium phosphate.
Under NO circumstances is it allowable to give a pt the undiluted strong solution, unless she wants to kill the pt.
johnep

[bleepholder]

Under NO circumstances is it allowable to give a pt the undiluted strong solution, unless she wants to kill the pt.
johnep

I'd ahve to disagree with you there on that one....undiluted potassium (1mmol/ml) can be given to those with a central line isnerted, usually those on intensive care!!

[johnep]

Fair enough if a pt in say, renal failure then every ml of wter counts. However, would expect staff on ITU and Renal wards to be much more experienced then on a general ward. Wonder where the pt have a bronchoscopy was when 10x sod phos soln used.
johnep

[DavidS]

Potassium chloride was, according to novellist Jonathan Kellerman, the lethal injection of choice on death row in the good ole US of A, although because it is a rather nasty way to go they would administer it with some other sedating drugs.

[bleepholder]

Fair enough if a pt in say, renal failure then every ml of wter counts. However, would expect staff on ITU and Renal wards to be much more experienced then on a general ward. Wonder where the pt have a bronchoscopy was when 10x sod phos soln used.
johnep

yeah i'd also hope staff on ITU to be more experienced up there with neat potassium.....its also not just those with renal failure who are fluid restricted....easy way to up the potassium..especially when you want to consistently keep it above 5!!!

as to the bronchoscopy patient...i hadn't heard of it, but i'm guessing they were on a normal ward with nurses who probably didn't quite know what they were doing....