Multiple forms of calcium exist with varying amounts of elemental calcium expressed in varying units. Therefore careful attention is required in prescription and administration of calcium to avoid over- or under-dosing.
Conversion factor for elemental Ca: 1 mg = 0.02 mmol = 0.05 mEq.
Prescribe calcium in mmol/kg/dose (not in mL/kg/dose)
Calcium can slow the heart rate and precipitate arrhythmias. In cardiac arrest, calcium may be given by rapid intravenous injection. In the presence of a spontaneous circulation give it slowly.
Do not give calcium solutions and sodium bicarbonate simultaneously by the same route to avoid precipitation.
Calcium chloride 10% may be preferred over calcium gluconate 10% for rapid IV administration.
Calcium gluconate in glass vials should not be used for repeated or prolonged treatment due to the high aluminium content.
| 