The ECG is your serum potassium is extra-vitro hemolysis. This “pseudo hyperkalemia” occurs for several reasons: blood vials are agitated vigorously or dropped prior to testing. In these instances, red blood cells lyse, releasing potassium, causing the potassium Lever to rise in the tube. This is not a laboratory error; the potassium lever is, in face, high in the tube, but not the patient