Calcium Chloride

Aliases: None  

Indications: Calcium channel- or beta-blocker overdose, hyperkalemia, hypocalcemia, hypermagnesemia, Hydrofluoric acid burn, Blood product transfusion; Cardiac arrest with presumed hyperkalemia or calcium channel-blocker overdose; Pulseless VF/VT. 

Contraindications: None in the emergency setting 

Concentrations: 

Injection: 100mg/mL

Dosing

Adult:

Indication Dose Route Note 
-Known or suspected hyperkalemia 
-Hemorrhagic Shock 
-Severe Hydrofluoric Acid Burn 
-Calcium channel or Beta blocker overdose		1,000mg
(1 gram) 		IV Push Ensure that the IV/IO line
is patent before giving
the medication 

Pediatric:

Indication Dose Route Note 
-Known or suspected hyperkalemia 
-Hemorrhagic Shock 
-Severe Hydrofluoric Acid Burn 
-Calcium channel or Beta blocker overdose		20mg/kg
max 1,000mg
(1 gram) 		IV Push Ensure that the IV/IO line
is patent before giving
the medication 
Use Handtevy or Approved Pediatric Reference Guide for Amount to Administer 

Precautions: Will cause tissue damage if it extravasates   

Adverse/Side Effects: Arrhythmias including bradycardia or cardiac arrest, Syncope, N/V, Hypotension, Necrosis with extravasation. Calcium chloride will precipitate when used in conjunction with sodium bicarbonate, Toxicity with digitalis, and may antagonize the effects of calcium channel blockers  

Class: Inotropic Agent (electrolyte)  

Mechanism of Action: Replaces elemental calcium, which is essential for regulating excitation threshold of nerves and muscles. Calcium is also essential for blood clotting mechanisms, maintenance of renal function, and bone tissues. Calcium increases myocardial contractile force and ventricular automaticity. Additionally, it serves as an antidote for magnesium sulfate and calcium channel blocker toxicity.   

Onset of ActionPeak EffectDuration of Action 
ImmediateImmediateVaries