Calcium gluconate − IV intermittent

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Administration Calcium gluconate − IV intermittent

Calcium gluconate − IV intermittent

Draw up 4.5 mL (1.0 mmol) and add 5.5 mL of sodium chloride 0.9%, glucose 5% or glucose 10% to make a final volume of 10 mL with a concentration of 0.1 mmol/mL. Infuse dose over 10−60 minutes via a central line (if possible).

Calcium gluconate – cardiac arrest (secondary to hyperkalaemia, hypocalcaemia, hypermagnesaemia or calcium channel blocker)

Infuse undiluted over 5 – 10 minutes via a central line (if possible).

Administration

Calcium gluconate − IV intermittent

In cardiac arrest secondary to hypocalcaemia, hyperkalaemia, magnesium toxicity or calcium channel blocker overdose, calcium may be given by rapid intravenous injection.

In the presence of a spontaneous circulation give it slowly. Infuse dose over 10−60 minutes (5-10 minutes in cardiac arrest) via a central line (if possible and compatibilities permit). If NO central access is available, consult the Neonatologist on service before administering via peripheral route. If administering peripherally give via a large vein.

In poorly perfused patients, consider diluting the infusion further (two-fold) and infuse over at least TWO hours.

MUST NOT be injected intra-arterially, intramuscularly or subcutaneously.

Monitoring

Continuous ECG monitoring to monitor heart rate and rhythm (stop infusion if HR < 100 bpm).

Measurement of ionised calcium preferred over total calcium.

Blood gas machines measure ionised calcium directly and are more accurate than the main pathology laboratory which calculates the ionised calcium from a complex formula.

Observe IV tubing for precipitates.

Observe IV insertion site for extravasation.

Correct hypomagnesaemia if present.

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