Prehospital administration of calcium in trauma

Background Calcium depletion in haemorrhagic shock is associated with pathophysiology detrimental to survival. Aim The purpose of this systematic literature review was to determine whether paramedic administration of calcium for haemorrhagic shock could reduce trauma morbidity and mortality. Method The MEDLINE and CINAHL databases were searched for publications relevant to hypocalcaemia management in traumatic haemorrhage. Findings Fourteen peer-reviewed articles met the inclusion criteria. These examined incidence, morbidity, mortality and treatment options for hypocalcaemia associated with traumatic haemorrhage. Paramedicine can play a key role in managing hypocalcaemia early and determining the effect this has on improving patient outcomes from severe trauma. Conclusion The findings in this review link hypocalcaemia to poor yet potentially modifiable outcomes in trauma. Ambulance services should consider empiric treatment with calcium when shocked patients are expected to receive blood transfusion for traumatic haemorrhage.

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