Hypocalcemia

Background

• Low <8.5 (<2.0 ionized)
• Low! <6.5 (<1.5 ionized)

• Correct for hypoalbumimia
  • Corrected Ca = (0.8 * (Normal Alb - Pt's Alb)) + Serum Ca

Diagnosis

Signs/Symptoms

1. Paresthesias
2. Inc DTRs
3. Cramps
4. Weakness
5. Confusion
6. Sz
7. Chvostek's/Trouseau's
8. ECG
   1. QT prolongation

DDX

1. Shock
2. sepsis
3. renal failure
4. cimetidine
5. hypoparathyroid
6. inc phos
7. vit D def
8. fat embolism
9. strychnine
10. hypomag
11. tetanus

Treatment

1. Asymptomatic
   1. calcium gluconate 1 gm PO Q6hrs
   2. vitamin D (calcitriol) 0.2 mcg BID
2. Symptomatic
   1. calcium gluconate/chloride 10mL of 10% sol over 10min IV

Source

2/12/06 DONALDSON (adapted from Tintinalli)