Hyperkalaemia ECG

Metabolic

Recognition

  • Peaked T waves
  • Prolonged PR
  • Wide QRS
  • Loss of P
  • Sine wave (pre-arrest)

Key findings

  • Changes correlate roughly with K⁺ severity

Clinical importance

  • Risk of VF / asystole

Management pearls

  • Calcium gluconate 10 mL 10% IV — stabilise membrane
  • Insulin 10 U + 25 g glucose
  • Salbutamol nebs
  • Sodium bicarbonate if acidotic
  • Definitive: dialysis
WardRound

WardRound

Clinical Decisions in Seconds