The use of calcium in cardiac resuscitation

All records of cardiac arrest patients presenting to the Tampa EMS system for the 24-month period of January, 1980, through December, 1982, were reviewed. Paramedics were given direct orders or standing orders to administer calcium intravenously or intracardiac in patients in ventricular fibrillation, asystole, or electromechanical dissociation. Of the 480 patients receiving calcium for the above conditions, only patients with electromechanical dissociation responded to calcium. Twenty-seven EMD patients responded positively with the immediate return of blood pressure and pulse. Fourteen of these patients arrived at the emergency department with stable vital signs; there were three long-term survivors. Adverse rhythm or rate changes were not noted following calcium use, and arrhythmias associated with digitalis excess were not seen in a small group of patients taking digoxin. Although long-term survivors are limited in this group of patients, positive hemodynamic responses were seen following calcium chloride administration in 10% of EMD patients and not at all in patients with asystole or ventricular fibrillation.