In this episode we briefly review hyperkalemia and the principles of emergent treatment. Then we explore, in-depth, the role of insulin and dextrose including the incidence of hypoglycemia and pearls to reduce this side effect. Pearls: 10-20% of patients treated with insulin/dextrose for hyperkalemia get hypoglycemic Consider giving 5 units insulin instead of 10 units Check the glucose for hours (dextrose lasts <1 hr, insulin lasts ≥2 hours) Beware of insulin in patients with renal insufficiency or with near normal starting glucose. Thanks for listening! Lauren