Hypophosphatemia in the emergency department therapeutics.
Although hypophosphatemia is relatively uncommon, it may be seen in anywhere from 20% to 80% of patients who present to the ED with alcoholic emergencies, diabetic ketoacidosis (DKA), and sepsis. Severe hypophosphatemia, as defined by a serum level below 1.0 mg/dL, may cause acute respiratory failure, myocardial depression, or seizures. Because hypophosphatemia is not as often treated by ED physicians, becoming familiar with a single intravenous phosphate solution and specific guidelines for phosphate repletion are essential. One mL of the most commonly available phosphate solution (K2PO4) contains 4.4 meq of potassium and 3 mmol (93 mgs) of phosphate. Administering K2PO4 at a rate of 1 mL per hour is almost always a very safe and appropriate treatment for hypophosphatemia. This article provides guidelines for phosphate therapy in hypophosphatemic ED patients including those in DKA, those presenting with alcohol-related complaints including alcoholic ketoacidosis and patients with acute exacerbation of asthma and chronic obstructive pulmonary disease.
Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA.
D W
DW
Miller
C M
CM
Slovis
D000437:Alcoholism / Q000150:complications; D001249:Asthma / Q000150:complications; D016883:Diabetic Ketoacidosis / Q000150:complications; D004638:Emergency Treatment; D006801:Humans; D017674:Hypophosphatemia / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D008173:Lung Diseases, Obstructive / Q000150:complications; D017410:Practice Guidelines as Topic