Calcium Gluconate

Dilution guide

Indication

Hyperkalaemia (membrane stabilisation), hypocalcaemia, Mg toxicity, CCB overdose.

Preparation

10 mL of 10% Ca gluconate = 1 g (≈ 2.3 mmol Ca²⁺).

Dilution

Bolus undiluted slow IV over 5–10 min, or in 50–100 mL NS.

Rate

Hyperkalaemia: 10 mL IV; may repeat in 5 min.

Monitoring

  • ECG (T-wave/QRS)
  • Ca level
  • Phosphate
  • Extravasation

Common errors

  • Mixing with bicarbonate or phosphate → precipitate
  • Use Ca chloride only via central line

Pearls

  • Onset within 1–3 min; lasts 30–60 min — definitive K⁺ shift needed
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WardRound

Clinical Decisions in Seconds