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Severe shock, obtunded, and a diagnostic prehospital ECG. Also: How did this happen?

Dr. Smith's ECG Blog

This is pathognomonic of hyperkalemia (I suppose it could be due to a massive overdose of a sodium channel blocking drug, maybe). Internal potassium balance and the control of the plasma potassium concentration. She was in shock with thready pulses. A prehospital ECG was recorded: Limb leads: Precordial Leads What is the therapy?

Plasma 52