Pediatric Clinical Pharmacy
Potassium Chloride Replacement Guidelines for Neonatal and Pediatric Patients
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Approved PICU PI 5/8/06
Approved NICU PI
Oral Potassium Replacement
* Preferred route of administration for non-emergent replacement
(Serum K greater than or equal to 3 mEq/L)
Serum Potassium Oral or GT Potassium Chloride 20 mEq/15 ml Liquid
3-3.4 mEq/L 0.5-1 mEq/kg/dose (max 40 mEq/dose) x 1 dose
<3 mEq/L 1 mEq/kg/dose (max 40 mEq/dose) q 2 hours x 2 doses
Intravenous Potassium Replacement
Neonatal patients REQUIRE Attending Approval for Bolus IV potassium replacement
Pediatric patients need Attending or Chief resident approval for Bolus IV replacement
* Indicated for patients unable to tolerate or receive oral replacement
* For patients with urine output > 1 ml/kg/hour and serum Cr < 1 mg/dl
for patients with renal impairment use lower doses and recheck potassium between doses
* recheck potassium 4 hours after dose
* Add or adjust potassium in maintance IV fluids
* All patients require cardiac monitoring for concentrated Potassium doses
Concentrations >80 mEq/l or doses > 0.2 mEq/kg/hour
Peripheral IV
** Maximum concentration 1 mEq/10 ml (premix 10 mEq/100 ml SW)
Serum Potassium
3-3.4 mEq/L 0.5 mEq/kg/dose over 2 hours (max 10 mEq/dose) 1 dose
*** see above note on oral replacement
< 3 mEq/L 1 mEq/kg/dose over 2 hours (max 10 mEq/dose) up to 2 doses
Central Line Access
** Maximum concentration 1 mEq/5ml (premix 20 mEq/100 ml SW)
(for extreme fluid restriction may use 1mEq/2.5 ml-premix 40 mEq/100ml SW)
3-3.4 mEq/L 1 mEq/kg/dose over 2 hours (max 20 mEq/dose) 1 dose
< 3 mEq/L 1 mEq/kg/dose over 1 hour (max 20 mEq/dose) up to 2 doses
