Hyperkalaemia medical — DipIMC MCQ

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HardMedical EmergenciesHyperkalaemia medicalDipIMC

A 58-year-old dialysis patient feels faint after missing two sessions. The ECG shows tall tented T waves and broadening QRS; he remains conscious. What is the most appropriate drug/dose?

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Correct answer: E — Give intravenous calcium gluconate according to local protocol

Give intravenous calcium gluconate according to local protocol is the best answer because ECG changes of hyperkalaemia require immediate membrane stabilisation with IV calcium. Give oral antihistamine as first-line treatment is less appropriate because antihistamines do not treat airway, breathing or circulation compromise; Give nebulised salbutamol as sole treatment is less appropriate because bronchodilator therapy may help wheeze but does not treat systemic shock. Give intramuscular adrenaline 1 mg and Delay medication until hospital review are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; Resuscitation Council UK Guidelines