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Prehospital blood linked to arrival hypocalcaemia in trauma

Prehospital factors associated with calcium derangements upon arrival to the trauma center from scene - A subanalysis of a multicenter prospective study
The American Journal of Emergency Medicine · 2026-09-23 · Added 29 October 2026

A US prospective multicentre subanalysis of 1,047 trauma patients brought by EMS found calcium derangements on arrival associated with lower survival, with 56.6% of the 136 patients given prehospital blood hypocalcaemic on arrival and 5 hypercalcaemic patients having received prehospital calcium.

Study type

Cohort

Design

Preplanned subanalysis of a prospective multicentre observational study

Participants

1,047 EMS-transported trauma patients at 3 US trauma centres

Main finding

235 patients hypocalcaemic and 39 hypercalcaemic on arrival, both associated with lower survival; 77 of 136 (56.6%) who received prehospital blood were hypocalcaemic; 5 hypercalcaemic patients had received prehospital calcium, suggesting possible iatrogenic hypercalcaemia.

Caveat

Subgroup analysis confounded by indication — the sickest patients were the ones given blood, and calcium was not measured before arrival.

Bottom line

Hypothesis-generating

Learning goal

Strengthen my judgement on when prehospital blood products may drive calcium derangements in major trauma.

More

• Topic: Trauma
• Daily scan: 29 October 2026
• Podcast: Paramedic Papers Daily, 29 October 2026

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