* Examples of High Risk Patients: Dialysis, Renal Transplant, CKD under renal team. Previous Hyperkalaemia.

** All patients being discharged need to be discussed or seen by a Tier 3+ level Dr who will assign themselves to the patient. Put the Diagnoses as ‘No abnormality Detected’ AND ‘Potassium Level.’

Streaming Pathway

Patients POC results, ECG and PMH reviewed.

Make sure the patients contact number is correct. Inform them if their lab result comes back high then we will contact them. OPer them the choice if the result is normal – would they like a phone call or not. Add their choice to the bubble I.e ‘no call’ ‘wants call’

Move the patient to the ‘Streaming’ Tab and record the time they left in the bubble. Once the lab result is back, if it is raised then recall the patient for treatment. If it is normal then discharge from the system ensuring to put the discharge time as when they left the department.

If the lab sample haemolyses – The decision to recall is at the discretion of the Tier 3+ doctor.

Notes

This pathway has been created as a guide to help reduce the investigation burden and length of stay of patients with pseudo-hyperkalaemia. The purpose of having an Tier 3+ level doctor responsible for these patients is they can make a quick global assessment of the patient and decide whether the patient is high risk and if the streaming pathway is appropriate, rather than relying on a regimented list of conditions or parameters.

In hours this should be done by the front door doctor. Out of hours Tier 1/2 doctors can still see these patients but they should then be discussed with a Tier 3+ Doctor.