Potassium
Patients with HHS are potassium deplete but less acidotic than those with DKA so potassium shifts are less pronounced, the dose of insulin is lower, and there is often co-existing renal failure. Hyperkalaemia can be present with acute kidney injury and patients on diuretics may be profoundly hypokalaemic. Potassium should be replaced or omitted as required
- >5.5 mmol/l none
- 3.5-5.5 mmol /l 20 mmol/500 ml bag (i.e. 40 mmol/l)
- <3.5 mmol/l senior advice is required, and pharmacy involvement may be needed. The patient MUST be looked after in a high dependency care.