Accepted at: Sep, 20, 2024 6:43 a.m.
Author: tensor_tympani
Related Deck: 1675118865074
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What is the initial management of acute severe hypercalcaemia (serum total Ca > 3.0 mmol/L)?

{{c1::0.9% NaCl IV infusion over 24 hours}}
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<b><span style="font-weight: 400;">What is the </span><span style="font-weight: 400; text-decoration-line: underline;">initial</span><span style="font-weight: 400;"> management of </span>acute severe hypercalcaemia<span style="font-weight: 400;"> (serum total Ca &gt; 3.0 mmol/L)?<br></span></b><br><div>{{c1::0.9% NaCl IV infusion over 24 hours}}</div>
Extra
Monitor cardiac function until serum calcium is reduced to a safe concentration (ie within or slightly above the normal range). Hypercalcaemia increases the risk of cardiac complications, particularly in older people and patients with a history of cardiac disease. Intravenous furosemide (frusemide) can be used under specialist supervision to treat fluid overload following rehydration. Do not use furosemide for primary treatment of hypercalcaemia because it can deplete intravascular volume further.

Use IV biphosphonates in patients who do not respond to rehydration
Extra
<div>Monitor cardiac function until serum calcium is reduced to a safe concentration (ie within or slightly above the normal range). Hypercalcaemia increases the risk of cardiac complications, particularly in older people and patients with a history of cardiac disease. Intravenous furosemide (frusemide) can be used under specialist supervision to treat fluid overload following rehydration. Do not use furosemide for primary treatment of hypercalcaemia because it can deplete intravascular volume further.</div><br><div>Use IV biphosphonates in patients who do not respond to rehydration</div>
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Oxford Handbook
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Oxford Handbook
First Aid
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First Aid
AMBOSS
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AMBOSS
eTG Complete
eTG Complete
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Talley & O'Connor
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Talley & O'Connor
Additional Resources
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Additional Resources
Source
Hypercalcaemia eTG article accessed 5 september 2024:&nbsp;<a href="https://tgldcdp-tg-org-au.eu1.proxy.openathens.net/viewTopic?etgAccess=true&amp;guidelinePage=Bone%20and%20Metabolism&amp;topicfile=hypercalcaemia&amp;guidelinename=Bone%20and%20Metabolism§ionId=toc_d1e123#toc_d1e123">https://tgldcdp-tg-org-au.eu1.proxy.openathens.net/viewTopic?etgAccess=true&amp;guidelinePage=Bone and Metabolism&amp;topicfile=hypercalcaemia&amp;guidelinename=Bone and Metabolism&amp;sectionId=toc_d1e123#toc_d1e123</a>&nbsp;Updated March 2021
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#Malleus_CM::#Subjects::Surgery_&_EM::20_Acute_Electrolyte_Abnormalities::Acute_Hypercalcaemia::10_Management #Malleus_CM::#Subjects::Endocrinology::04_Parathyroid_Gland::Hypercalcaemia::*General #Malleus_CM::#Resources_by_Rotation::Emergency #Malleus_CM::#Resources_by_Rotation::Intensive_Care #Malleus_CM::#Resources_by_Rotation::Internal_Medicine::Endocrinology #Malleus_CM::#Question_Banks::eMedici::4000-4999::4773 #Malleus_CM::#eTG_Complete::Antibiotic::Respiratory_tract_infections:_pneumonia::Hospital-acquired_pneumonia