Survey of practices around the measurement and replacement of calcium in paediatric major trauma - Report - MDSpire

Survey of practices around the measurement and replacement of calcium in paediatric major trauma

  • By

  • Owen Hibberd

  • Melanie Ranaweera

  • Spyridon Karageorgos

  • Kat Priddis

  • Ruud G Nijman

  • Andrew Tagg

  • Dani Hall

  • Damian Roland

  • June 17, 2026

  • 0 min

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Clinical Report: Assessment of Calcium Measurement and Replacement Practices in Pediatric Major Trauma Cases

Overview

This study surveyed practices regarding calcium measurement and replacement in pediatric major trauma across 67 emergency departments. Findings indicate variability in protocols and practices.

Background

Ionised hypocalcaemia can exacerbate hemorrhage, affecting clot formation and cardiac function. Current guidelines lack specificity on when to measure or replace calcium in pediatric trauma cases.

Data Highlights

FindingDetails
EDs with major haemorrhage protocol61/67 (91.0%)
EDs including calcium in protocol51/67 (76.1%)
Protocols specifying timing of calcium replacement23/67 (34.3%)
Variation in opinions on calcium replacementVaried based on patient stability

Key Findings

  • 91.0% of EDs had a pediatric major hemorrhage protocol.
  • 23.9% of EDs did not include calcium in their protocols.
  • 65.7% of protocols did not specify the timing for calcium replacement.
  • Opinions on calcium replacement before blood products varied based on patient stability.
  • Opinions on replacement doses differed for moderately low calcium levels but not for severely low levels.

Clinical Implications

The variability in practices regarding calcium measurement and replacement in pediatric trauma is noted.

Conclusion

The study reveals variation in calcium management practices in pediatric trauma.

Related Resources & Content

  1. Frontiers in Pediatrics, 2026 -- Prognostic Value of Admission Ionized Calcium for Short-Term Mortality in Critically Ill Children With Sepsis: A Single-Center Retrospective Cohort Study
  2. conexiant -- Adjusted Calcium Is Lying — And Labs Keep Printing It
  3. Critical Care -- Should we change our approach to detecting citrate accumulation in patients treated with CRRT with regional citrate?
  4. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition - PMC
  5. Prevalence and outcomes of hypocalcemia on ED arrival in traumatic patients before blood transfusions: a systematic review and meta-analysis | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
  6. The Journal of Clinical Endocrinology & Metabolism — Global Insights on Monitoring Approaches for X-linked Hypophosphatemia in Pediatric and Adult Populations: Findings from Expert Survey
  7. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition - PMC
  8. Prevalence and outcomes of hypocalcemia on ED arrival in traumatic patients before blood transfusions: a systematic review and meta-analysis | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Springer Nature Link
  9. https://transfusionontario.org/wp-content/uploads/2021/10/Recommendation-Statements-_FinalDraft_Mar2025-V2.pdf

Original Source(s)

Survey of practices around the measurement and replacement of calcium in paediatric major trauma

  • by Owen Hibberd, Melanie Ranaweera, Spyridon Karageorgos, Kat Priddis, Ruud G Nijman, Andrew Tagg, Dani Hall, Damian Roland

  • June 17, 2026

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