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The Effects of Using Prehospital Calcium Gluconate During Cardiopulmonary Resuscitation: A Retrospective Study

Thongpitak Huabbangyang1, Agasak Silakoon1, Suchanaree Soimongkolchai1

  • 1Department of Emergency Medical Operation, Faculty of Science and Health Technology, Navamindradhiraj University, Bangkok 10300, Thailand.

Archives of Academic Emergency Medicine
|February 11, 2026
PubMed

Insights

Prehospital administration of calcium gluconate (CG) during cardiopulmonary resuscitation (CPR) did not improve survival outcomes for out-of-hospital cardiac arrest (OHCA) patients. Selective use of calcium is recommended over empirical administration.

Area of Science:

  • Emergency Medicine
  • Cardiology
  • Clinical Research

Background:

  • Calcium gluconate (CG) is not routinely recommended for cardiopulmonary resuscitation (CPR).
  • The impact of prehospital CG administration on out-of-hospital cardiac arrest (OHCA) outcomes requires investigation.

Purpose of the Study:

  • To examine the effect of prehospital calcium gluconate administration on OHCA patient outcomes.
  • To compare return of spontaneous circulation (ROSC), survival to hospital admission, and survival to discharge between patients who received CG and those who did not.

Main Methods:

  • Retrospective cohort study of adult non-traumatic OHCA patients.
  • Data collected from emergency medical service (EMS) reports and electronic medical records.
  • Comparison of outcomes between OHCA cases receiving CG versus those not receiving CG.

Main Results:

  • Calcium gluconate administration was associated with lower rates of ROSC at the scene (8.6% lower).
  • CG administration correlated with significantly lower survival to hospital admission (16.48% lower).
  • Survival to hospital discharge was also lower in patients who received CG (7.37% lower).

Conclusions:

  • Prehospital CG administration by EMS did not improve OHCA survival outcomes.
  • Findings suggest a need for selective calcium use based on guidelines, not empirical administration.
Abstract

Keywords:
Calcium gluconateCardiopulmonary resuscitationOut-of-hospital cardiac arrestOut-of-hospital heart arrestPrehospital emergency care

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