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Calcium in cardiac resuscitation

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Trials show no benefit of calcium administration in cardiac resuscitation. Theoretically, it should improve excitation-contraction coupling and increase automaticity, but calcium causes cell death and ischaemia.

Calcium is indicated during resuscitation from pulseless electrical activity if this is thought to be caused by:

  • hyperkalaemia
  • hypocalcaemia
  • overdose of calcium-channel-blocking drugs
  • overdose of magnesium (e.g. during treatment of pre-eclampsia)

In adults, the initial dose of 10 ml 10% calcium chloride (6.8 mmol Ca2+) may be repeated if necessary

Notes:

  • calcium can slow the heart rate and precipitate arrhythmias
  • in cardiac arrest, calcium may be given by rapid intravenous injection. In the presence of a spontaneous circulation it should be given slowly
  • do not give calcium solutions and sodium bicarbonate simultaneously by the same venous access.

Reference:

  1. Resuscitation Council (UK). Adult Advanced Life Support. Resuscitation Guidelines 2005.

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