eMedicine Specialties > Emergency Medicine > Endocrine & Metabolic

Hypocalcemia: Follow-up

Author: Christopher B Beach, MD, FACEP, FAAEM, Assistant Professor and Vice Chair, Department of Emergency Medicine, Assistant Professor of Institute for Healthcare Studies, Institute for Patient Safety, Feinberg School of Medicine, Northwestern University
Contributor Information and Disclosures

Updated: Mar 9, 2009

Follow-up

Further Inpatient Care

  • Care is determined by the probable underlying etiology of hypocalcemia.
  • Many patients require ICU or ward admission for inpatient workup and repeat laboratory testing.
  • If a patient is given intravenous calcium in the ED, admit for further evaluation and observation.

Further Outpatient Care

  • Although uncommon, outpatient evaluation by an endocrinologist or an internist is appropriate in some cases.
  • Oral repletion should be initiated in the ED, with a clear plan for timely follow-up care.

Transfer

  • Transfer should be considered when the etiology of hypocalcemia requires a subspecialty that is not available at the initial hospital.

Deterrence/Prevention

  • Patients with diseases that predispose them to the development of hypocalcemia should have scheduled appointments with an outpatient provider.

Prognosis

  • Prognosis is dependent on the etiology of hypocalcemia but is generally good.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Hypocalcemia generally results from another disease process. Recalling the diseases that cause hypocalcemia is important so that the cause can be identified and managed early.
  • Failure to consider hypoalbuminemia as the cause of hypocalcemia
  • Failure to consider laboratory error as the cause of hypocalcemia
 


More on Hypocalcemia

Overview: Hypocalcemia
Differential Diagnoses & Workup: Hypocalcemia
Treatment & Medication: Hypocalcemia
Follow-up: Hypocalcemia
References
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References

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Further Reading

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Keywords

hypocalcemia, calcium, calcium regulation, smooth muscle contraction, hypoalbuminemia, calcitonin, calcium homeostasis, spurious hypocalcemia, calcium gluconate, hyperparathyroidism, celiac sprue, low calcium, low blood calcium, calcium deficiency, ionized hypocalcemia, cardiovascular collapse, hypotension, dysrhythmias, tetany, seizures, muscle cramping, bronchospasm, tetanic contractions, distal extremity numbness, tingling sensations, cataracts, psoriasis, chronic pruritus, syncope, congestive heart failure, CHF, angina, laryngeal stridor, dysphagia, biliary colic, intestinal colic, gluten intolerance, preterm labor, detrusor dysfunction, focal numbness, muscle spasms, Chvostek sign, Trousseau sign, carpal spasm, irritability, confusion, hallucinations, dementia, extrapyramidal manifestations, hypomagnesemia, hyperphosphatemia, PTH deficiency, PTH resistance, vitamin D deficiency, vitamin D resistance, cirrhosis, nephrosis, malnutrition, burns, sepsis, acute pancreatitis, alcoholism, rhabdomyolysis, toxic shock syndrome, high calcitonin levels, osteoblastic metastases, breast cancer, prostate cancer, tumor lysis syndrome, hepatic insufficiency, renal insufficiency, sarcoidosis, tuberculosis, hemochromatosis, hydrofluoric acid burn, hydrofluoric acid ingestion, renal failure, mesenteric ischemia, massive blood transfusion, radiocontrast dyes, high bicarbonate levels, high lactate levels, parathyroid adenoma resection, parathyroid injury, pancreatectomy, small bowel syndrome, DiGeorge syndrome, idiopathic hypoparathyroidism, Wilson disease, metastatic cancer, pseudohypoparathyroidism, Albright disease, rickets, hepatorenal disease

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Contributor Information and Disclosures

Author

Christopher B Beach, MD, FACEP, FAAEM, Assistant Professor and Vice Chair, Department of Emergency Medicine, Assistant Professor of Institute for Healthcare Studies, Institute for Patient Safety, Feinberg School of Medicine, Northwestern University
Christopher B Beach, MD, FACEP, FAAEM is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Robin R Hemphill, MD, MPH, Associate Professor, Director, Disaster Preparedness, Department of Emergency Medicine, Vanderbilt University Medical Center
Robin R Hemphill, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey L Arnold, MD, FACEP, Chairman, Department of Emergency Medicine, Santa Clara Valley Medical Center
Jeffrey L Arnold, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine and American College of Physicians
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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