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
-
Objective:
To survey the practices, protocols and opinions regarding the measurement and replacement of calcium in pediatric major trauma.
Approach:
- Survey Methodology: A cross-sectional survey was conducted with voluntary and snowball sampling among emergency departments (EDs) and clinicians.
Key Findings:
- 91% of 67 EDs had a pediatric major hemorrhage protocol, but 24% did not include calcium.
- 65.7% of protocols did not specify the timing for calcium replacement.
- Opinions on calcium replacement before blood products varied significantly based on patient stability.
- No significant differences in opinions on replacement doses for severe ionised hypocalcaemia (<1.0 mmol/L) regardless of stability.
Interpretation:
Limitations:
- The survey may not represent all EDs globally due to its design.
- Responses were based on clinician opinions, which may not reflect actual practices.
Conclusion:
More research is needed to establish consensus on calcium measurement and replacement in pediatric trauma protocols.
