If the patient presents with total

If the patient presents with total paralysis of the extremities but is still able to swallow and breathe adequately, oral sips of KCl solution can be given, 15 to 30 mmol (in children 10 to 15 mmol) in 30 to 60 minute intervals. The release from KCl tablets is too slow. If no improvement is apparent after four to five oral doses, or if nausea or diarrhea occurs after the oral KCl intake, IV administration of KCl is necessary. This also is preferable in patients with acute attacks of paralysis, cardiac distress or ischemia, arrhythmias, difficulties in swallowing and impaired respiration.

Using a peripheral vein, the preferred dose for intravenous K+ is 15 mEq (15 mmol) over 15 minutes then 10 mEq/hr (10 mmol/hr) in 500 ml of dilutant. Five percent Mannitol is the solution of choice for IV administration of K+. Mannitol (which is inert) should be used as the solvent (rather than saline or dextrose, which are both potential triggers of attacks).Glucose must never be used. Infusion must be continued until serum K+ is normal and the patient's strength returns. Cardiac function must be continuously monitored during IV administration of potassium. 4,5,6,9.