When should calcium be administered to patients receiving blood products?

Calcium administration in patients receiving blood products is important due to the potential for hypocalcemia, especially when large volumes of citrated blood products are transfused. Citrate is used as an anticoagulant in stored blood, and it binds to calcium in the bloodstream, which can lead to decreased calcium levels as more blood is infused.

By administering calcium before and after every unit of blood product, you help mitigate the risk of hypocalcemia. This proactive approach allows for maintaining appropriate calcium levels throughout the transfusion process and addresses any potential hypocalcemic effects immediately after the transfusion as well. This is particularly crucial in patients receiving multiple units or in those with pre-existing conditions that may exacerbate the effects of citrate.

This strategy enhances patient safety by ensuring that calcium levels remain stable in the face of citrate-induced calcium binding. In contrast, administering calcium only before, during, or after the transfusion may not adequately manage the fluctuations in calcium levels that can occur during the transfusion process.