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Hyperkalaemia ECG stabilisation — FRCA Primary MCQ

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HardPharmacologyHyperkalaemia ECG stabilisationFRCA Primary

Immediately before induction, a patient has potassium 7.1 mmol/L and broad QRS complexes. Which treatment should be given first?

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Correct answer: E — Give 10 mL of 10% calcium chloride intravenously

The best answer is “Give 10 mL of 10% calcium chloride intravenously”. Severe hyperkalaemia with ECG changes requires immediate membrane stabilisation with intravenous calcium. Resuscitation Council UK specifies 10 mL of 10% calcium chloride over five minutes when available. Potassium-shifting and removal measures follow, but they do not replace immediate cardiac protection.

Reference: Resuscitation Council UK, Special circumstances guidelines: https://www.resus.org.uk/professional-library/2025-resuscitation-guidelines/special-circumstances-guidelines