In pediatric hyperkalemia, which dose is used for calcium chloride?

In pediatric hyperkalemia, which dose is used for calcium chloride?

• A. 20 mg/kg IV/IO over 2 min (FIRST)
• B. 1 mg/kg IV/IO
• C. 50 mg/kg IV/IO
• D. 2 mg/kg IV/IO

Answer: (A)

In pediatric hyperkalemia, calcium is given to stabilize the heart’s membrane so it’s less likely to develop dangerous rhythms while you address the high potassium. This is a rapid, temporary protective measure, not a potassium-lowering treatment. The approved dose for calcium chloride is 20 mg/kg given IV or IO over about 2 minutes (using a 10% solution, that’s 0.2 mL/kg). This should be given first to quickly safeguard the myocardium, then you move on to therapies that actually reduce or shift potassium (insulin with glucose, albuterol, bicarbonate if needed, and measures to remove potassium). Note that calcium gluconate, if used, is given at a different dose (typically 60 mg/kg), since calcium chloride contains more elemental calcium per milliliter.

In pediatric hyperkalemia, calcium is given to stabilize the heart’s membrane so it’s less likely to develop dangerous rhythms while you address the high potassium. This is a rapid, temporary protective measure, not a potassium-lowering treatment. The approved dose for calcium chloride is 20 mg/kg given IV or IO over about 2 minutes (using a 10% solution, that’s 0.2 mL/kg). This should be given first to quickly safeguard the myocardium, then you move on to therapies that actually reduce or shift potassium (insulin with glucose, albuterol, bicarbonate if needed, and measures to remove potassium). Note that calcium gluconate, if used, is given at a different dose (typically 60 mg/kg), since calcium chloride contains more elemental calcium per milliliter.