Hypocalcemia

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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

  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)

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