'Near-miss' hyperkalaemic cardiac arrest associated with rapid blood transfusion

A case is presented in which a relatively modest blood transfusion resulted in acute hyperkalaemia with a 'near-miss' cardiac arrest. While transfusio n-related hyperkalaemia usually occurs in association with massive transfus ions, several factors may have increased the risk of such an acute reaction . A high index of suspicion is required, especially in patients with risk f actors. Anaesthetists should not be lulled into a false sense of security s imply because modest volumes of blood are being transfused.