Electrolytes

Section 8 - MEDICATION GUIDELINES

8.14 ELECTROLYTES

Calcium Chloride

DESCRIPTION

• It may increase myocardial contractile force and may increase ventricular automaticity.

INDICATIONS

• To counteract Magnesium Sulfate used in Eclampsia, hyperkalemia, and hypocalcemia.

CONTRAINDICATIONS

• It may precipitate toxicity in patients taking Digitalis.

PRECAUTIONS

• Ensure the IV line is flushed before using Calcium Chloride.

DOSAGE

• 5 - 7 mg / kg AND per physician's orders. Refer to the Handtevy System WMD protocol page for dosage.

Magnesium Sulfate

DESCRIPTION

• It is an anticonvulsant, especially effective in the control of seizures associated with eclampsia.

INDICATIONS

• Seizures due to eclampsia (toxemia of pregnancy), consider contacting MEDICAL CONTROL for orders for Torsades de pointes.

CONTRAINDICATIONS

• Patients with heart block or recent myocardial infarction.

PRECAUTIONS

• May cause hypotension, circulatory collapse, or cardiac and respiratory depression. Calcium Chloride should be available to counteract the untoward effects of Magnesium.

DOSAGE

• Refer to appropriate PRACTICE PARAMETER for specific dosages.
• Refer to Handtevy System infusion instructions for dosage.

Sodium Bicarbonate (NaHCO3)

DESCRIPTION

• It provides bicarbonate to assist the buffer system in reducing the effects of acidosis.

INDICATIONS

• Crush Syndrome, severe acidosis, prolonged cardiac arrest, and tricyclic anti-depressant overdose.

CONTRAINDICATIONS

• None when used in severe hypoxia or late Cardiac Arrest.

PRECAUTIONS

• May cause alkalosis if administered too aggressively.
• It may also deactivate vasopressors, and may precipitate with Calcium Chloride.

DOSAGE

• Refer to appropriate PRACTICE PARAMETER for specific dosages AND per physician's orders.
• Refer to Handtevy System for pediatric dosage.