[Skip to Content]
[Skip to Content Landing]
March 4, 1988

Calcium in Electromechanical Dissociation

JAMA. 1988;259(9):1330. doi:10.1001/jama.1988.03720090022026

To the Editor.  —We noted that in the latest standards for emergency cardiac care published in JAMA,1 calcium was no longer recommended as a drug to be given for electromechanical dissociation. Furthermore, the guidelines for neonatal advanced life support state that "there is no current evidence that two previously recommended drugs, atropine and calcium, are useful in the acute phase of neonatal resuscitation."1 Overall, this recommendation seems reasonable, since calcium may have a detrimental role in cardiac disease2,3 and has not been shown to be of benefit in prehospital cardiac arrest4 or in the treatment of electromechanical dissociation.5,6 However, in a certain subset of patients it may deserve another look. We report two cases in which a 10% infusion of gluconate calcium (0.5 mL/kg) immediately corrected hyperkalemia-associated electromechanical dissociation.

Report of Cases. 

Case 1.  —Triplet "C" was a girl born at 28 weeks of gestation