INS and Hyperkalemia: Most of ED management was directed for treatment of hyperkalemia and pulmonary fluids overload (Fig. 2). The ED administered non-invasive ventilation (NIV) (33%), Calcium gluconate (33%), insulin with dextrose (32%), diuretics (30%), and nebulization with salbutamol (24%), antibiotics (20%), nitrates (19%) and sodium bicarbonates (16%).