Calcium Chloride in EMS || EMS Pharmacology
💊 Calcium Chloride 💊
When it comes to medications, the way to my heart as an EMS provider is when a drug has multiple uses. Calcium chloride, although not commonly used used in the prehospital setting, has a plethora of indications.
Let’s talk about them!
Beta blocker & calcium channel blocker overdoses - Calcium chloride is used as an antidote in the case of BB and CCB overdoses. The administration of calcium chloride can improve the heart rate and cardiac 🫀 function by increasing the overall force of contractions. Another option in these cases is glucagon.
Magnesium overdoses - While this scenario is unlikely to be identified out in the EMS field, calcium may be a useful tool for a magnesium overdose. In the case of a pregnant patient 🤰🏼 overdosed on magnesium (due to eclampsia, preeclampsia, preterm labor, etc.), calcium can serve as a reversal agent.
Hyperkalemia - I did not want to include this in the list because it is debatable in the 911 prehospital setting. 911 EMS providers do not typically have access to lab values 🧪 . There is not a way we can put a value to what a patient’s potassium is, therefore EMS providers aren’t out there routinely administering calcium to “fix” hyperkalemia. There is, however, indicators of hyperkalemia on a 12 lead (which we 100% have access to in the prehospital setting). Look out for those tall, peaked T waves and/or sine waves. Follow your protocol for when to administer calcium chloride (or calcium gluconate, if that is what you carry).
And just to be clear, there are situations that cause hyperkalemia that we treat (like crush injuries, diabetic ketoacidosis, etc.), but hyperkalemia alone is more complex in the prehospital setting. When all else fails, CALL MEDICAL CONTROL!
Hypocalcemia - This indication tends to be seen in interfacility transports where the physician has evaluated the bloodwork and lab values of the patient. The physician will base the dose and rate on the patient’s specific deficiency and underlying cause.
#calciumchloride #emspharmacology #paramediceducation #emseducator #lightssirensactionems #lightssirensaction
When it comes to medications, the way to my heart as an EMS provider is when a drug has multiple uses. Calcium chloride, although not commonly used used in the prehospital setting, has a plethora of indications.
Let’s talk about them!
Beta blocker & calcium channel blocker overdoses - Calcium chloride is used as an antidote in the case of BB and CCB overdoses. The administration of calcium chloride can improve the heart rate and cardiac 🫀 function by increasing the overall force of contractions. Another option in these cases is glucagon.
Magnesium overdoses - While this scenario is unlikely to be identified out in the EMS field, calcium may be a useful tool for a magnesium overdose. In the case of a pregnant patient 🤰🏼 overdosed on magnesium (due to eclampsia, preeclampsia, preterm labor, etc.), calcium can serve as a reversal agent.
Hyperkalemia - I did not want to include this in the list because it is debatable in the 911 prehospital setting. 911 EMS providers do not typically have access to lab values 🧪 . There is not a way we can put a value to what a patient’s potassium is, therefore EMS providers aren’t out there routinely administering calcium to “fix” hyperkalemia. There is, however, indicators of hyperkalemia on a 12 lead (which we 100% have access to in the prehospital setting). Look out for those tall, peaked T waves and/or sine waves. Follow your protocol for when to administer calcium chloride (or calcium gluconate, if that is what you carry).
And just to be clear, there are situations that cause hyperkalemia that we treat (like crush injuries, diabetic ketoacidosis, etc.), but hyperkalemia alone is more complex in the prehospital setting. When all else fails, CALL MEDICAL CONTROL!
Hypocalcemia - This indication tends to be seen in interfacility transports where the physician has evaluated the bloodwork and lab values of the patient. The physician will base the dose and rate on the patient’s specific deficiency and underlying cause.
#calciumchloride #emspharmacology #paramediceducation #emseducator #lightssirensactionems #lightssirensaction