Hyperkalaemia ECG — DipIMC MCQ

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ModerateMedical EmergenciesHyperkalaemia ECGDipIMC

A dialysis patient collapses at home but has a pulse. The ECG shows broad QRS complexes and tall tented T waves. What is the most appropriate immediate action?

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Correct answer: A — Protect the myocardium with intravenous calcium within governance

Explanation lettering: B = shown as A · D = shown as B · E = shown as C · A = shown as D · C = shown as E

B is correct: Severe hyperkalaemia with ECG changes is immediately life-threatening and calcium stabilises the myocardium. A is less suitable because it does not address the discriminator in the vignette; C is less suitable because it delays the immediate life-saving step in the cABCDE sequence; D is less suitable because a detailed survey is inappropriate before correcting an immediate threat; E is less suitable because it moves the patient before the decisive threat or destination issue is addressed. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Guidelines; Resuscitation Council UK; NICE guidance where applicable