UNCONTROLLED WHEN PRINTED
Introduction
- 2.2 mmol / 10ml vial (0.22mmol/ml)
- Provides immediate stabilisation of the myocardium in hyperkalaemia
- Opposed blockade of calcium channels by drugs; alters membrane polarisation; chelates fluoride ions
- Onset 1-3 minutes
- Peak duration 30-60 minutes
Indications
- Major haemorrhage where 2 or more units of Red Blood Cells have been administered
- Crush Injury with ECG signs associated with hyperkalaemia
- ECG Signs of Hyperkalaemia
- Tall tented T-waves
- Absent p-waves
- Widened QRS
- Sine Wave
- Calcium channel blocker toxicity (particularly verapamil or diltiazem)
Contraindications
- Hypersensitivity
- Suspected Digoxin Toxicity
Precautions / Notes
- This is a HIGH-RISK medication and is rapidly fatal in overdose
- Monitor ECG with IV administration
- Extravasation can cause tissue necrosis; do not give via SC or IM routes. Monitor the injection site closely
- If given too fast it may cause hot flushes, chalky taste, peripheral vasodilation, hypotension, bradycardia, cardiac dysrhythmias, syncope and cardiac arrest
Management
Critical Care Paramedic only
- Adult
- 10ml (2.2 mmol) IV/IO slow push over 3-5 minutes
- Repeat dose once or twice if required (titrated against ECG changes)
- Paediatric
- 0.7ml/kg (0.15 mmol/kg) IV/IO slow push over 3-5 minutes to a maximum dose 10ml (2.2 mmol)
- Repeat dose once or twice if required (titrated against ECG changes)
Special Considerations
- Allergy
- Vasodilation / Syncope
- Hypotension
- Bradycardia
- Cardiac Dysrhythmias
References
References
Presentation
- 2.2mmol in 10mL (0.22 mmol / ml) solution for injection
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