A 76-year-old man presents CTAS 1 with weakness and near-syncope. ECG shows a sine-wave pattern, HR is 38, BP is 86/52, potassium is 7.4 mmol/L, and

Question

A 76-year-old man presents CTAS 1 with weakness and near-syncope. ECG shows a sine-wave pattern, HR is 38, BP is 86/52, potassium is 7.4 mmol/L, and creatinine is 390 µmol/L. He takes ramipril and spironolactone. What is the most appropriate next step?

Accepted Answer

Give IV calcium, then insulin-dextrose and potassium removal therapy

Answer

Start oral sodium polystyrene as sole therapy

Answer

Wait for repeat potassium before treatment

Answer

Give adenosine for bradycardia

Answer

Transfer for dialysis before membrane stabilisation

Severe hyperkalaemia with ECG changes — RCPSC EM MCQ

A 76-year-old man presents CTAS 1 with weakness and near-syncope. ECG shows a sine-wave pattern, HR is 38, BP is 86/52, potassium is 7.4 mmol/L, and creatinine is 390 µmol/L. He takes ramipril and spironolactone. What is the most appropriate next step?