Potassium ladder and sodium correction limits

Hyperkalaemia with ECG change is a membrane emergency. Calcium stabilises myocardium without lowering K; insulin–glucose shifts K intracellularly (hypoglycaemia risk, especially non-diabetic low-glucose patients) and pairs synergistically with salbutamol; bicarbonate is uncertain except severe acidosis comorbidity; binders/removal per local protocol — SPS no longer recommended, newer binders per local guidance.^[1][2]

Sodium and hypokalaemia. Acute symptomatic hyponatraemia → hypertonic saline to reverse cerebral oedema; chronic hyponatraemia → slow correction with ODS risk in view, after volume-status classification. Replace magnesium to enable potassium repletion; limit peripheral K infusion rates — confirm all numbers against local electrolyte protocol.^[3][4][5]