Calcium Chloride 10% Infusion

Question 1

Clinical condition or situation to which this PGD applies

Answer 1

Known or suspected hyperkalemia or hypocalcaemia in adult patients.

Question 2

Inclusion criteria

Answer 2

Adults only

Cardiac arrest and known or suspected hyperkalemia (potassium greater than 6mmol per litre)

Known or suspected hyperkaelmia (potassium changes plus presence of ECG changes

Hypocalcaemia

Overdose of calcium channel blocking drugs

Empiric use after 4U of blood products being given

Question 3

Exclusion criteria

Answer 3

Paediatrics

Patients receiving cardiac glycosides i.e. Digoxin

Known or suspected hypercalcemia

Hypersensitivity to calcium chloride or any of the excipients

Question 4

Cautions

Answer 4

Great care should be taken to avoid extravasation or accidental injection into perivascular tissue

Injection should be made slowly through a small needle into a large vein to minimise venous irritation and avoid undesirable reactions

Question 5

Dose and frequency

Answer 5

A Single dose of 10ml (10%) Calcium Chloride

In hypovolemic patients who have received 8 units of blood then a further dose of calcium may be administered.

Question 6

Adverse effects

Answer 6

Rapid IV injection may cause the patient t complain of tingling sensations, calcium taste, sense of oppression or ‘heat wave’. Calcium chloride injections are accompanied by peripheral vasodilation and local burning sensation

Necrosis if intramuscular injection and or extravasation occurs

Soft tissue calcification, bradycardia or arrhythmias have also been reported

Hypertension

Venous thrombosis

Hypercalcemia