Role of Calcium in pediatric resuscitations

Does calcium have any usefulness in pediatric resuscitations? 

The American Heart Association does not recommend the routine use of calcium in pediatric cardiac arrest. Although the use of calcium during resuscitation has declined considerably, there remain specific instances when it has significant value. Use calcium to remedy the following situations:

  • • Documented hypocalcemia
  • • Documented hyperkalemia
  • • Documented hypermagnesemia
  • • Calcium channel blocker excess

When administered, calcium should be infused slowly. Rapid infusion results in severe bradycardia. Take care to avoid back-to-back infusion of calcium and sodium bicarbonate–containing solutions. If mixed, these agents form calcium carbonate (chalk) in the IV tubing. 

Sources

American Heart Association: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Part 10: Pediatric Basic and Advanced Life Support. Circulation 2010;122:S466-S515.

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