Neobook — clinical reference

Potassium [K+] 2- 3mmol/L
Potassium [K+] 1.5-2mmol/L
Potassium [K+] <1.5mmol/L

KCl = Potassium Chloride / 1ml of 15% KCl = 2mmol K⁺

Potassium [K⁺] 2- 3mmol/L

Clinical features: lethargy, ileus, abdominal distension

Weight	Stat dose of oral KCl	If ongoing loses prescribe KCl orally 3x/day	Further management
< 5kg	250mg	125mg	If normalising just continue replacing ongoing losses. Stop when no more ongoing losses
5-10kg	500mg	250mg
>10kg	1g	500mg
Re-check 4 hourly

Potassium [K⁺] 1.5-2mmol/L

Clinical features: floppiness, bradycardia
ECG findings: flat T waves, prolonged QT

Weight	Stat dose oral KCl	PLUS IV Correction: Take a 200ml bag of fluid add 15% KCl as below (=40mmol/L) & infuse at [maintenance + rehydration] rate*		PLUS prescribe Oral KCl
< 5kg	250mg	½ DD	2ml of 15% KCl	100/mg/kg 6hrly Max. 3g/day
5-10kg	500mg	PMS	3ml of 15% KCl
>10kg	1g	N/Saline	4ml of 15%KCl
Re-check 4 hourly

*Do not infuse 40mmol/L KCl correction fluid at Rapid Rehydration (20ml/kg/hr) rate

Potassium [K⁺] <1.5mmol/L

Clinical features: paralysis/profound muscle weakness, diplopia, apnoea
Cardiac findings: ventricular fibrillation, cardiac arrest

Weight	Stat dose oral KCl	PLUS IV Correction: Take a 200ml bag of fluid add 15%KCl as below (=40mmol/L) & infuse at [maintenance + rehydration] rate		Consider KCl Infusion ONLY UNDER ADVICE OF PICU or referral centre
< 5kg	250mg	½ DD	2ml of 15% KCl	0.15ml/kg 15% KCl in 50ml N/Saline via central vein over 1hr NEVER BY BOLUS
5-10kg	500mg	PMS	3ml of 15% KCl
>10kg	1g	N/Saline	4ml of 15%KCl
Re-check hourly for 2 hours – if improving check 2-4 hourly

*Do not infuse 40mmol/L KCl correction fluid at Rapid Rehydration (20ml/kg/hr) rate

Reference: Adapted from Handbook of Paediatrics, 7th Ed (2010). P480 Fig 20.6 Management of Hypokalaemia. Motala C, A Davidson, A Figaji and M Levin. Oxford University Press SA.

Hypokalaemia - Emergency Management in Children

Drugs mentioned