EM Cases · ECG — the deadly patterns
Deadly ECG patterns — hyperkalaemia and the wide complex
ACEM Fellowship resus station testing hyperkalaemia ECG recognition, calcium-first ladder, and avoidance of misclassifying sine wave as primary VT.
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Study tools
Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
A dialysis patient with progressive weakness whose ECG evolves from peaked T waves toward a sine-wave wide complex requiring calcium-first therapy and urgent dialysis.
Station brief
Format. Clinical-management (resus) station, 11 minutes. You lead the resuscitation.
Candidate instructions. Manage the patient using ECG findings. State doses and monitoring. The examiner plays nursing staff. [2]
References2ShowHide
- [1]Thygesen K, Alpert JS, Jaffe AS, et al. Fourth Universal Definition of Myocardial Infarction (2018). Circulation, 2018.PMID 30571511
- [2]Kim HJ, Han SW. Therapeutic approach to hyperkalemia. Nephron, 2002.PMID 12401936