Meeting abstracts from the IRC Nation Congress—Italian Resuscitation Conference 2025

BackgroundHyperkalaemia is a potentially life-threatening electrolyte disturbance commonly encountered in emergency settings.This study aims to describe the clinical characteristics, management, and outcomes of hyperkaliaemic patients presenting to the emergency department (ED), and to evaluate adherence to international treatment guidelines. Materials and MethodsWe analysed adult patients presenting with hyperkalaemia (serum potassium 5.5 mmol/L) to the ED of Santa Croce e Carle Hospital in Cuneo, Italy, during 2023-2024.Patients in terminal condition or receiving palliative care were excluded.Adherence to European Resuscitation Council guidelines was evaluated based on appropriate administration of calcium and insulin/salbutamol.Results 215 patients were included (median age 81 [74-87] years; median Charlson index 6 [5;8]).Potassium levels 6.5 mmol/L were observed in 43.7% of cases.Acute kidney injury was present in 74.4% of patients.ECG abnormalities occurred in 46.5%, mainly bradycardia (18.6%) and Scand J Trauma Resusc Emerg Med 2026, 33:173 peaked T waves (12.6%).Calcium and insulin/salbutamol were appropriately administered in 73.5% and 72.1% of cases, respectively.Overall guideline adherence was 49.8%.Thirty-day mortality was 15.8%, and was associated with older age (p=0.011),lower eGFR (p<0.001), and lower bicarbonate levels (p=0.001).No significant mortality difference was found based on adherence to treatment guidelines (p=0.27). ConclusionsHyperkalaemia in the ED commonly affects elderly, multimorbid patients.Despite frequent ECG changes and severe biochemical abnormalities, adherence to treatment guidelines remains suboptimal; however mortality was not clearly associated with adherence to treatment guidelines.The suboptimal appropriateness of treatment may reflect the clinical complexity and frailty of this population, in whom standard interventions may be deferred or modified due to comorbidities, risks of overtreatment, or limited physiological reserve. A3Out-of-hospital management of post-traumatic external hemorrhage: an observational survey among emergency nurses