NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 5305

POLICIES AND PROCEDURES

Subject: Medical Direction

Associated Policies: 01/07/98

1. Class:

1. Electrolyte.

2. Indications:

1. Hyperkalemia in renal dialysis patients.
2. Hypocalcemia.
3. Calcium channel blocker toxicity.
4. Black widow spider bites.
5. Magnesium sulfate overdose.

3. Therapeutic Effect:

1. Increases serum calcium levels.

4. Contraindications:

1. Absolute:

1. Hypercalcemia.

1. Relative:

1. Digitalis therapy - (Use with caution, may cause ventricular fibrillation or bradycardia).

5. Adverse Effects:

1. Bradycardia.
2. Asystole.
3. Hypotension.
4. Nausea and vomiting.
5. Peripheral vasodilatation.

6. Administration and Dosage:

1. Adult: 500 mg to 1 gram (5 ml to 10 ml ) of 10% solution, IV slowly over 60 seconds, may repeat once in 10 minutes, if necessary.
2. Pediatric: 20 - 25 mg/ kg (0.2 -0.25 ml/ kg) of 10% solution, IV slowly over 60 seconds.

7. Special Information:

1. Precipitates if mixed with Sodium Bicarbonate (into Calcium Bicarbonate).
2. Potent local irritant at injection site.