Electrolyte Disturbances - Hypocalcaemia

Can be due to poor intake (especially Ex-prems), hypoparathyroidism, abnormal vitamin D production or action, hyperphosphatemia, malabsorption and others. 

• IV: 
  • Calcium gluconate 10% give 0.5ml/kg (max 20ml) bolus prn 
  • 1mmol/kg/day (5ml/kg/day)can be added to 24hr fluid requirements 
  • Do not confuse with Calcium chloride 10% (Dose 0.2ml/kg!) 
• Oral: 
  • Calcium carbonate 420 mg Tablets (Titralac) = 168 mg elemental calcium 
  • 1m - 3yr: 1 tab 2-3 x daily 
  • 4yr - 12yr : 2 tab 3x daily 

NB: Don’t give with meals unless you want to bind phosphate. Do not give with oral phosphate.