Normal saline bolus (10–20 mL/kg)
10% calcium chloride, 5–10 mL, or 10% calcium gluconate, 10–20 mL, over 5 minutes
Atropine, isoprenaline (isoproterenol) and/or pacing may be tried if associated symptomatic bradycardia
Dopamine infusion if persistent hypotension
Begin insulin euglycaemia therapy in any patient whose resuscitation requires more than just IV fluids as there is normally a delay in effect
Insulin bolus, 1 unit/kg with glucose, 50% dextrose, 25 ml i.v.
Insulin infusion, 0.5 units/kg/hour with 50% dextrose infusion, 0.5 g/hour, adjusted according to hourly glucose checks
As a last resort, extracorporeal blood pressure support (e.g. cardiopulmonary bypass) may be considered