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Calcium can be given by slow IV push; however, the author prefers a piggyback calcium infusion be given to asymptomatic patients in an effort to avoid a rapid infusion of calcium. For ease of use and preparation, calcium gluconate should be ordered in 1 gm dose increments. Calcium chloride may be used, preferably in code situations, but not for routine replacement therapy as the chloride salt contains about 2.5 times the amount of elemental calcium and can cause tissue necrosis when given peripherally in contrast to calcium gluconate. However, other clinicians prefer the routine use of calcium chloride for the treatment of hypocalcemia.
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