Potassium chloride with calcium chloride and sodium chloride

How it works

It restores extracellular fluid volume and supplies sodium, potassium, calcium and chloride ions in physiological proportions to correct or prevent depletion and maintain electrolyte balance.

Prescribing in practice

• Because it contains potassium, avoid or use with great caution in renal impairment, hyperkalaemia or conditions predisposing to potassium retention, as accumulation can precipitate dangerous arrhythmias.
• The calcium content makes it incompatible with co-administration of blood products through the same line, as it can promote clotting of citrated blood.
• Use with caution in cardiac failure, oedematous states and hypertension where the sodium and volume load may worsen fluid overload.

Monitoring

Monitor serum electrolytes, fluid balance and renal function during infusion, especially in those at risk of potassium retention or fluid overload.

Counselling the patient

• Explain that this is a drip to replace body fluids and salts.
• Report breathlessness, swelling or palpitations during the infusion.

Evidence & guidelines

Balanced crystalloids of this type are established for perioperative and resuscitation fluid replacement, with guidance favouring balanced solutions over excessive use of sodium chloride alone in many settings.