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Calcium Chloride vs Calcium Gluconate


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Specializes in ICU. Has 2 years experience.

thank you. do you take into consideration the sr creatinine when replacing calcium?

calivianya, BSN, RN

Specializes in ICU.

thank you. do you take into consideration the sr creatinine when replacing calcium?

Nope - we only take creatinine into consideration for K+ replacement. Sorry for the slow response.

1. Replace Ca based on your ionized calcium from your ABG. This will remove the need to correct for the pt's albumin (do you think the albumin level you have from pre-op is the same as it is post-op? Do you get post-op albumins?). If iCal on the gas is

2. Push the amp slowly. I leave it in line on a runner and give 1 mL every minute or so. Slam the whole amp and you will get hypertension and maybe some arrhythmias.

3. Don't use Ca Gluconate in liver failure. The calcium is attached to a gluconate molecule that requires processing by the liver to convert it into usable Ca. CaCh is immediately useable by the body and this is why it has a faster onset.

4. You should have a very low threshold to give an amp of CaCh to a hypotensive pt, even if you don't know their serum calcium. Most vasopressors work by increasing the release of intracellular calcium, so if your Ca is low your pressors will not work as well. And critically ill patients are almost always hypocalcemic and, even if they aren't, the amp won't hurt them if you push it slow.


Has 3 years experience.

Calcium chloride has three times as much elemental (physiologically available) calcium as calcium gluconate.

And as mentioned earlier, it should also be administered via central line since Calcium's vasoconstrictive effects.


Specializes in CCU/ICU, CVICU, CTICU, CSU. Has 15 years experience.

We've gotten patients back in a code situation after giving CaCl.. we use it as protocol on our unit for anyone with an ionized calcium


Except when all you have is a peripheral iv.