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Life-threatening hyperkalaemia — RCPSC EM MCQ

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HardCardiovascular emergenciesLife-threatening hyperkalaemiaRCPSC EM

A dialysis patient missed two sessions and presents weak with HR 38. ECG shows wide QRS complexes and peaked T waves. Potassium is 7.4 mmol/L and BP is 86/50. What is the most appropriate initial management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Intravenous calcium, insulin with dextrose, beta-agonist therapy and urgent dialysis planning

Hyperkalaemia with ECG instability requires immediate membrane stabilisation with calcium, intracellular shifting and definitive removal, often dialysis.

Reference: Heart and Stroke ACLS principles; Canadian nephrology hyperkalaemia practice