This article explores the assessment and management considerations of patients with hyperkalaemia. Using a case study from clinical practice, the hospital treatment is reviewed with particular emphasis upon the use of calcium, insulin and dextrose. In particular, potential prehospital treatments are considered, with focus upon the use of salbutamol and furosemide. Definitions, incidence and mortality rates of hyperkalaemia are also detailed. The signs, symptoms and causes of the condition are examined, with the aim of achieving prehospital diagnosis in the absence of serum potassium levels. Hyperkalaemic electrocardiogram (ECG) changes are studied and examples are given. Conclusions are made, including a recommendation for the prehospital use of salbutamol in the treatment of hyperkalaemia