Potassium chloride with sodium chloride

How it works

It corrects or prevents hypokalaemia while sodium chloride replaces extracellular sodium and supports fluid volume.

Prescribing in practice

• Use only ready-mixed solutions infused at a controlled rate; concentrated potassium given too rapidly or as a bolus can cause fatal cardiac arrhythmias.
• Avoid or use cautiously in hyperkalaemia and renal impairment and with drugs that raise potassium such as ACE inhibitors and potassium-sparing diuretics.
• The sodium load can contribute to fluid overload and hypernatraemia, so use with caution in cardiac failure and oedematous states.

Monitoring

Monitor serum potassium and sodium, ECG and fluid balance during infusion, especially with rapid replacement or renal impairment.

Counselling the patient

• Explain this drip replaces potassium and salt-water.
• Report palpitations, muscle weakness or discomfort at the infusion site.

Evidence & guidelines

Ready-to-use potassium-in-sodium-chloride bags are recommended over bedside addition of potassium ampoules to reduce serious medication errors.