1. What are the EKG manifestations associated with hyperkalemia? Do these changes occur in a particular order? 
2. What is the role of Kayexalate in the treatment of hyperkalemia?
3. Is there a threshold serum potassium level or particular EKG finding that triggers you to administer calcium? How do you give calcium when you use it?
4. When do you re-dose patients you’ve treated for hyperkalemia?
EM Lyceum 
Some of my colleagues routinely give IV CaGluconate for significant hyperkalemia, even in the absence of arrhythmias. Is this necessary or wise?
Dr. Mitchiner: thank you for your question and your reading of the site. The question of when to give calcium (gluconate or chloride) is #3 on our hyperkalemia questions for this month, the “answers” to which are to be published shortly. In brief, there doesn’t appear to a set guideline or evidence basis for giving calcium based on severity of hyperkalemia, although consensus and “expert” recommendation typically includes severity as a reason to give it. This appears to be even in the absence of EKG changes, for the sake of stabilizing cardiac myocytes that have not yet evidenced a clinical change but may do so soon.