ECG progression
- Peaked T → PR ↑ → wide QRS → sine wave → VF
Cardioprotection
- Calcium gluconate 10% 10 mL IV over 5 min, repeat to 30 mL
Shift
- Insulin 10 U + 25 g glucose
- Salbutamol 10–20 mg neb
- NaHCO₃ 1.26% if pH <7.2
Remove
- Resonium / patiromer
- Dialysis if refractory / AKI
