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Question: Hypocalcemia

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Last week’s 10 day old patient presented with seizures and jitteriness due to hypocalcemia. In the ED, he has a peripheral 22 gauge IV placed. 

Which of the following is most appropriate treatment for his symptomatic hypocalcemia?

pemsou5_wp • December 14, 2021

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  1. Kelly December 17, 2021 - 6:54 pm Reply

    D) 10% Calcium gluconate 100 mg/kg (1 mL/kg) IV over 10-20 minutes
    Calcium chloride is more rapid acting but causes more irritation to peripheral veins, so in pediatric patients without central venous access, calcium gluconate is often used. If a central line is present, calcium chloride is preferred. However, calcium should not be pushed through a UAC as it may cause arterial spasm and reduced intestinal bloodflow. Outside a cardiac arrest situation, calcium should be given more slowly, over 10-20 minutes. Rapid infusion can cause bradycardia. An IO line is not needed nor superior if a functioning IV is in place.

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