Paediatricscommon
An 8-year-old girl with chronic kidney disease is brought in vomiting after missing two dialysis sessions. She is alert and her blood pressure is 128/78 mmHg. Serum potassium is 7.4 mmol/L (3.5-5.0), bicarbonate 19 mmol/L and creatinine markedly raised. Her electrocardiograph shows tall peaked T waves with a QRS duration of 140 milliseconds. Her potassium-containing intravenous fluid has been stopped, cardiac monitoring is running and the renal registrar is on the way. Which one of the following should be given first?