Calcium in paediatric ALS

• calcium plays a vital role in the cellular mechanisms underlying myocardial contraction
  • however there are very few data supporting any beneficial action of therapeutic calcium following most cases of cardiac arrest
    • high plasma concentrations achieved after injection may have detrimental effects on the ischaemic myocardium and may impair cerebral recovery
    • calcium can slow the heart rate and precipitate arrhythmias.
  • therefore, calcium is given during resuscitation only when specifically indicated, for example in hyperkalaemia, hypocalcaemia, and clinically severe overdose of calciumchannel- blocking drugs
• dose of calcium chloride is 0.2 ml per kg of the 10% solution
  • in cardiac arrest, calcium may be given by rapid intravenous injection. In the presence of a spontaneous circulation it should be given slowly
  • calcium solutions and sodium bicarbonate should not be administered simultaneously by the same route

Reference:

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