Calcium Supplementation in Tactical Combat Casualty Care

Calcium is vital for coagulation and hemodynamic stability, with hypocalcemia correlating to higher mortality in trauma patients. Trauma-induced hypocalcemia is a critical issue in battlefield medicine, affecting both coagulation and cardiovas-cular function in severely injured individuals by exacerbating the effects of the lethal triad. TCCC is based on strategies to prevent and manage hemorrhage and shock, including the use of blood products and the administration of calcium to avoid citrate toxicity. However, there remains debate about whether calcium supplementation should be universally recommended, even in scenarios where blood products are unavailable. This paper examines evidence surrounding the inclusion of cal-cium in military trauma care protocols, weighing the benefits against potential risks and challenges.