Hypophosphatemia in the emergency department therapeutics

Although hypophosphatemia is relatively uncommon, it may be seen in anywher e from 20% to 80% of patients who present to the ED with alcoholic emergenc ies, diabetic ketoacidosis (DKA), and sepsis, Severe hypophosphatemia, as d efined by a serum level below 1.0 mg/dL, may cause acute respiratory failur e, myocardial depression, or seizures. Because hypophosphatemia is not as o ften treated by ED physicians, becoming familiar with a single intravenous phosphate solution and specific guidelines for phosphate repletion are esse ntial. One mt of the most commonly available phosphate solution (K2PO4) con tains 4.4 meg of potassium and 3 mmol (93 mgs) of phosphate. Administering K2PO4 at a rate Of 1 mt per hour is almost always a very safe and appropria te treatment for hypophosphatemia, This article provides guidelines for pho sphate therapy in hypophosphatemic ED patients including those in DKA, thos e presenting with alcohol-related complaints including alcoholic ketoacidos is and patients with acute excerbation of asthma and chronic obstructive pu lmonary disease.