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Hypocalcemia, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Hypocalcemia is defined as a total plasma calcium level <8.7 mg/dL:

    • Ionized calcium may be normal and, therefore, have no clinical manifestations.

  • Normal total serum calcium concent...

Diagnosis

Signs and Symptoms

  • Occur when ionized calcium <3.2 mg/dL

  • Dependent upon absolute calcium concentration and rate at which it falls

  • Neuromuscular:

    • Paresthesias

    • Hyperreflexia

    • Muscle spasm

    • Tetany:

      • Ne...

Treatment

Initial Stabilization/Therapy

ABCs: 
  • Establish IV catheter access.

  • Cardiac monitor

Ed Treatment/Procedures

  • Acute management:

    • Treat symptomatic hypocalcemia as a medical emergency with parenteral c...

Follow-Up

Disposition

Admission Criteria

  • Symptomatic or severe ionized hypocalcemia (<3.2 mg/dL)

  • Continuous IV calcium preparations necessary to maintain calcium levels

Discharge Criteria

  • Asymptomatic h...

Pearls and Pitfalls

  • Hypocalcemia has many causes

  • Treatment of hypocalcemia varies with its severity and underlying cause

  • Patients who are severely symptomatic require rapid correction with IV calcium th...

Additional Reading

  • Al-Azem  H, Khan  AA. Hypoparathyroidism. Best Pract Res Clin Endocrinol Metab.  2012;26(4):517–522.

  • Cooper  MS, Gittoes  NJ. Diagnosis and management of hypocalcemia. BMJ. ...

Codes

ICD9

  • 775.4 Hypocalcemia and hypomagnesemia of newborn

  • 275.41 Hypocalcemia

  • 275.5 Hungry bone syndrome

ICD10

  • E83.51 Hypocalcemia

  • E83.81 Hungry bone syndrome

  • P71.1 Other neonatal hypocalcemia

SNOMED

  • 5291005...

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