From the Guidelines
Calcium chloride has a rapid onset of action, typically within 1-3 minutes when administered intravenously, and its duration of action is relatively short, lasting approximately 30-60 minutes. The administration of calcium chloride is crucial in emergency situations such as severe hypocalcemia, hyperkalemia, or calcium channel blocker overdose, where it is preferred over calcium gluconate due to its higher elemental calcium content (27% vs 9%) 1. The typical adult dose is 500-1000 mg (5-10 mL of a 10% solution) administered slowly IV over 5-10 minutes with cardiac monitoring, as recommended by the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care 1. For cardiac arrest with hyperkalemia or calcium channel blocker toxicity, it may be given more rapidly, with a regimen of 10–20 mL (1–2 g) every 10–20 minutes or an infusion at 0.2–0.4 mL/kg/hr (0.02–0.04 g/kg/hr) 1. Some key points to consider when administering calcium chloride include:
- Administration through a central line when possible to minimize the risk of extravasation into surrounding tissues, which can cause severe tissue necrosis 1.
- Monitoring of serum calcium levels to guide therapy and prevent hypercalcemia 1.
- The potential need for repeated doses due to the short duration of action of calcium chloride 1. Overall, the use of calcium chloride in emergency situations requires careful consideration of the patient's clinical condition and close monitoring to ensure effective treatment and minimize potential adverse effects.
From the Research
Onset and Duration of Calcium Chloride
- The onset and duration of calcium chloride are not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, a study on the cardiovascular responses to calcium administered intravenously to man during halothane anesthesia found that calcium infusion significantly increased cardiac index, left ventricular minute work index, and stroke index 6.
- The study used calcium chloride (7 mg/kg) and measured cardiovascular changes during constant ventilation and anesthetic depth under three conditions: respiratory alkalosis, normocarbia, and respiratory acidosis 6.
- Another study mentions that calcium gluconate 10% dosed 10 mL intravenously should be provided for membrane stabilization, unless the patient is in cardiac arrest, in which case 10 mL calcium chloride is warranted 2.
- The duration of action of calcium chloride is not specified in the provided studies, but it is known that calcium plays a critical role in numerous body functions, including skeletal mineralization, signal transduction, nerve conduction, muscle contraction, and blood coagulation 5.