Introduction: The Calcium for Out-of-hospital Cardiac Arrest (COCA) trial highlighted the potential for harm with providing calcium during cardiac arrest and was terminated early due to concerns. During cardiac arrest, code blue teams attempt to achieve retorn of spontaneous circulation (ROSC) and may have limited information on the patient. This can lead to patients receiving medications such as calcium for suspected or known hyperkalemia or hypocalcemia. Methods: A total of 200 cardiac arrests were identified through the electronic medical record that used the code navigator between December 2024 and June 2025 at UK HealthCare. The code navigator is the documentation tool available within our EHR. The primary objective was to determine how many patients received intravenous (IV) calcium chloride. This is to serve as a baseline assessment for the institution. Secondary objectives included determining if the patient had known hyperkalemia or hypocalcemia during the cardiac arrest. Results: Of the 200 patients that experienced cardiac arrest 103 (51.5%) received calcium during cardiac arrest. Hypocalcemia was known in 28 (14%) of patients and hyperkalemia in 48 (24%) of patients. For those that received calcium during cardiac arrest, the median duration of the cardiac arrest was 21 minutes. Of the cohort 101 (50.5%) achieved ROSC, with 50 (49.5%) being in the calcium group vs 51 (50.5%) in the no calcium group. Conclusions: IV calcium administration is common within cardiac arrests, but should be limited to those patients with known indications for calcium.
Trott et al. (Sun,) studied this question.