Potassium Chloride Ampoule Content
Standard concentrated potassium chloride injection ampoules contain 10 mEq or 20 mEq of potassium chloride, with the most common formulation being 10 mEq in 5 mL (concentration of 2 mEq/mL) or 20 mEq in 10 mL.
Standard Ampoule Formulations
The FDA-approved concentrated potassium chloride injection is available in multiple formulations, with the most widely used being 1:
- 10 mEq total potassium chloride in 100 mL solution (concentration of 100 mEq/L or 0.1 mEq/mL) 1
- Traditional concentrated ampoules typically contain 2 mEq/mL concentration, meaning a 5 mL ampoule contains 10 mEq and a 10 mL ampoule contains 20 mEq 2, 3
Critical Safety Context
Concentrated potassium chloride ampoules should be removed from all clinical areas except intensive care units and stored in locked cupboards to prevent fatal medication errors. 4
The BMJ guidelines emphasize that approximately one-third of deaths from adverse drug reactions in hospitalized patients result from hyperkalemia caused by administration of excessively concentrated potassium solutions 2. These errors typically occur when nurses dilute concentrated ampoules at the bedside 2.
Evidence-Based Safety Recommendations
- Pre-mixed potassium-containing solutions should replace concentrated ampoules in all non-critical care areas 4, 2
- Concentrated ampoules must be kept in locked cupboards separate from all other solutions when they must remain in critical care areas 4
- A mandatory double-check policy must be instituted for all potassium preparation and administration 4
- Pharmacy-prepared infusions should be used whenever possible rather than bedside dilution 4
Clinical Administration Standards
When concentrated potassium chloride must be used, the standard dilution protocol involves 3, 5:
- 20 mEq potassium chloride in 100 mL normal saline (creating a 200 mEq/L concentration) administered over 1 hour 3, 5
- This concentration and rate (20 mEq/hour) has been demonstrated safe in intensive care unit patients with continuous cardiac monitoring 3, 5
- Mean serum potassium increase is approximately 0.25 mEq/L per 20 mEq infusion 5
Pediatric Dosing
In pediatric cardiac surgical patients, the standard supplementation protocol is 6:
- 0.5 mEq/kg potassium chloride infused over 2 hours via syringe pump 6
- This produces a mean serum potassium rise of 0.61 ± 0.48 mEq/L 6
- Serum potassium should be measured 15-30 minutes before and after infusion to monitor variable response 6
Common Pitfalls
- Never administer concentrated potassium chloride as an undiluted bolus—this can cause fatal cardiac arrest 4
- Do not transfer potassium ampoules between clinical departments, as this increases error risk 4
- Avoid incomplete or illegible prescribing of potassium concentrations 4
- Ensure ampoules are distinguishable from other injectable preparations through distinct labeling 4