Hypocalcemia

Background

Low <8.5 (<2.0 ionized)

Low! <6.5 (<1.5 ionized)

• Correct for hypoalbumimia

Diagnosis

Symptoms

1) paresthesias

2) inc DTRs

3) cramps

4) weakness

5) confusion

6) sz

7) Chvostek's/Trouseau's

8) prolonged QT

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

Asymptomatic

-calcium gluconate 1 gm PO Q6hrs

-vitamin D (calcitriol) 0.2 mcg BID

Symptomatic

-calcium gluconate/chloride 10mL of 10% sol over 10min IV

Source

2/12/06 DONALDSON (adapted from Tintinalli)