Internal medicine

Injury prevention

Hazard ratio

Poison control

Interquartile range

Surgery

Emergency medicine

Randomized controlled trial

Blunt trauma

Shock (circulatory)

Calcium

Anesthesia

Confidence interval

Medicine

Injury Severity Score

Calcium metabolism

Journal of Trauma and Acute Care Surgery

Randomized clinical trials (RCTs) support the use of prehospital plasma in traumatic hemorrhagic shock, especially in long transports. The citrate added to plasma binds with calcium, yet most prehospital trauma protocols have no guidelines for calcium replacement. We reviewed the experience of two recent prehospital plasma RCTs regarding admission ionized-calcium (i-Ca) blood levels and its impact on survival. We hypothesized that prehospital plasma is associated with hypocalcemia, which in turn is associated with lower survival.

Forgot calcium? Admission ionized-calcium in two civilian randomized controlled trials of prehospital plasma for traumatic hemorrhagic shock