Presentation
10%, 1gram in 10mL (6.8 mmol in 10mL) vial
Role
Calcium supplementation is recommended in the management of verapamil and diltiazem overdose along with appropriate inotropic and vasopressor therapy as indicated.
10% calcium chloride contains three times the elemental calcium in the same volume of 10% calcium gluconate.
Consultation with a clinical toxicologist through the local toxicology service or Poisons Information Centre on 13 11 26 is advised with all symptomatic calcium channel blocker poisonings.
Dose
10%, 10mL (6.8mmol calcium) [child: 0.2 mL/kg] IV, repeat q5min aiming for an ionised Ca between 1.5-2.0mmol/L.
Stocking recommendations
Calcium chloride is readily available given it is a standard resuscitation drug.
Precautions
Calcium chloride is irritating to veins. It is ideally given via central access, but in an emergency may be given peripherally through a proximal large bore cannula, while central access is gained.
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