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A 72-year-old man on bisoprolol 5 mg daily presents with severe hyperkalemia (K⁺ 6.8 mmol/L).
 ECG: QRS widening approaching sine-wave morphology.
 He has already received IV calcium, insulin–glucose, and 10 mg nebulised salbutamol with minimal improvement after 30 minutes.

What is the next most appropriate step?

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