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Hyperkalaemic cardiac arrest — DipIMC MCQ

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HardResuscitationHyperkalaemic cardiac arrestDipIMC

A 61-year-old dialysis patient collapses. The monitor shows sine-wave broad complexes before pulseless electrical activity, and relatives report he missed two dialysis sessions. What is the most appropriate drug/dose?

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Correct answer: A — Calcium chloride 10 mL of 10% IV with standard ALS for suspected hyperkalaemia

The history and ECG pattern suggest hyperkalaemic cardiac arrest, where calcium is a time-critical membrane stabiliser alongside ALS and other potassium-lowering measures. Adenosine treats selected supraventricular tachycardias, not hyperkalaemic arrest. Amiodarone does not address the underlying electrolyte cause. The pearl is that reversible causes are not theoretical; they should drive specific treatment during resuscitation.

Reference: Resuscitation Council UK Special Circumstances Guidelines 2025; JRCALC Guidelines 2025