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Hyperkalemia: protection is not removal

Educational use only. Not clinically reviewed

68-year-old man for Cardiac protection, shifting, individualized elimination, serial reassessment, and handoff. About 60 simulated minutes.

What you will practise

  • Protect the heart without mistaking ECG improvement for potassium removal.
  • Distinguish temporary shifting from potassium elimination.
  • Establish individualized removal and renal ownership.
  • Keep ECG, glucose, and full reassessments distinct.
  • Transfer unresolved risk and continued surveillance.

Review and sources

Not clinically reviewed. No clinician has signed this scenario.

  • UK Kidney Association. Clinical Practice Guideline: Management of Hyperkalaemia in Adults. December 2023. Sections 16–17 and 19: calcium, shifting, elimination, serial potassium and glucose surveillance, and individualized renal or critical-care decisions. No dose or universal schedule is reproduced.
  • Lindner G, Burdmann EA, Clase CM, et al. Acute hyperkalemia in the emergency department: a summary from a Kidney Disease: Improving Global Outcomes conference. European Journal of Emergency Medicine. 2020;27:329–337. doi:10.1097/MEJ.0000000000000691. Temporary calcium benefit, shifting without total-body removal, and rebound surveillance; a conference report, not a newly issued guideline.
  • Resuscitation Council UK. 2025 Resuscitation Guidelines: Special circumstances, Hyperkalaemia. Qualified calcium for severe hyperkalemia with ECG changes, insulin-glucose shifting, elimination, and individualized dialysis consideration for refractory severe hyperkalemia. This lesson concerns a perfusing adult, not cardiac arrest.

Every scenario in this module

Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.