Use of calcium in prehospital cardiac arrest

All records of patients presenting to the Milwaukee County Paramedic System for the period of January 1 to December 31, 1980 were reviewed retrospectively. One hundred seventy-nine patients initially presented in asystole, and 116 patients initially presented in electromechanical dissociation (EMD). All patients with trauma and poisoning were excluded. The in-field successful resuscitation rates for asystole were 8/105 (8%) in the calcium group versus 8/24 (33%) in the no-calcium group (P less than .002); for EMD they were 10/63 (16%) in the calcium group versus 8/18 (44%) in the no-calcium group (P less than .02). A successful resuscitation is defined as the conveyance of a patient to the emergency department with a pulse and cardiac rhythm. There were no significant differences between the calcium and no-calcium groups in both the asystole and EMD patients. The use of calcium in the prehospital setting in the currently recommended dosage for cardiac arrest with initial arrest rhythms of asystole and EMD is highly suspect.