ArticleScandinavian journal of trauma, resuscitation and emergency medicine2025
Prehospital measurement and treatment of ionised hypocalcaemia by UK helicopter emergency medical services in trauma patients: a survey of current practice.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Admission ionised calcium disturbances and adverse outcomes in paediatric major trauma: a UK multicentre retrospective cohort study.BMJ open · 2026Article
- The PaCOJournal of the Intensive Care Society · 2026Article
- Survey of practices around the measurement and replacement of calcium in paediatric major trauma.BMJ paediatrics open · 2026Article
- Early transfusion strategies in haemorrhagic shock.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Pre-hospital blood product transfusion and calcium management in the United Kingdom: a multicentre service evaluation.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Blood transfusion - moving from what to how.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Review
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5 authors.
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Abstract
backgroundIn the United Kingdom (UK), an increasing number of Helicopter Emergency Medical Services (HEMS) carry blood products for the resuscitation of patients with suspected haemorrhage. Ionised hypocalcaemia can occur due to calcium chelation from citrate-containing blood products or in response to traumatic injury. Therefore, many HEMS administer calcium alongside prehospital blood product transfusion. There are no national guidelines for prehospital calcium replacement. This study aimed to explore current UK HEMS protocols for calcium replacement associated with prehospital blood product transfusion and to report point-of-care testing (POCT) availability. The survey also sought to identify clinicians' opinions on the measurement, significance, and management of trauma-induced ionised hypocalcaemia in the prehospital setting.
methodsA cross-sectional survey with single-staged purposive sampling was conducted between 26th September and 15th November 2024. The survey explored standard operating procedures (SOPs) for calcium replacement, the incidence of POCT, and clinicians' opinions on the measurement and treatment of ionised hypocalcaemia. The survey was sent to the medical director, research lead, or a nominated clinician at the 21 HEMS in the UK on the 26th September 2024. These services were also invited to participate via a post on X (formerly Twitter) and a presentation delivered at the National HEMS Research and Audit Forum (NHRAF) on 26th September 2024.
results21 HEMS responded to the survey (100% response rate), and all carried prehospital blood products and calcium replacement therapy. Eleven different combinations of blood products were carried. 20/21 (95%) had a SOP for calcium replacement during prehospital blood product transfusion. POCT of ionised calcium (iCa
conclusionBlood products and calcium replacement therapy are now carried by all UK HEMS, but POCT is not in widespread use. Significant variation exists in the combination of products carried, protocols for calcium replacement, and opinions on the management of trauma-induced hypocalcaemia during prehospital transfusion, which suggests a need for further evidence.
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