Calcium Chloride

Provider Level

AEMT/RN/Paramedic

Class

Electrolyte

Mechanism of Action

Increases extracellular and intracellular calcium levels, enhancing myocardial contractile force and ventricular automaticity. Stabilizes myocardial cell membranes in hyperkalemia and antagonizes cardiovascular effects of magnesium and calcium channel blockers.

Indications

Hyperkalemia, hypocalcemia, calcium channel blocker toxicity, hypermagnesemia.

Contraindications

Ventricular fibrillation during resuscitation, hypercalcemia, suspected digitalis toxicity.

Routes

IV, IO

Onset / Duration

Onset is immediate. Duration is variable, typically 30 to 120 minutes.

Adverse Effects

Bradycardia, asystole, hypotension, metallic taste, severe tissue necrosis if infiltration occurs.

Precautions & Interactions

Extravasation causes severe tissue necrosis. Administer slowly. Use extreme caution in patients taking digitalis as it may precipitate toxicity. Flush IV line well before and after administration.

Special Considerations

Do not mix with sodium bicarbonate as precipitation will occur. Calcium chloride provides significantly more bioavailable calcium than calcium gluconate. Continuous ECG monitoring is required during administration.