In Crush Syndrome, what is the calcium chloride dose per the protocol?

• A. Sodium Bicarbonate: 50 mEq IV/IO over 2 min
• B. Normal Saline: 1 L
• C. Albuterol Nebulized: 10 mg
• D. Calcium Chloride: 1 g IV/IO (Peds: 20 mg/kg)

Answer: (D)

In crush syndrome, the immediate priority is protecting the heart from the dangerous effects of rising potassium as damaged muscle releases electrolytes. Calcium stabilizes cardiac membranes, making the heart less prone to arrhythmias while you address the high potassium. The protocol calls for giving calcium chloride to rapidly raise ionized calcium: 1 gram IV/IO in adults, with pediatric dosing of 20 mg/kg. This calcium administration is about membrane stabilization, not lowering potassium itself, so it’s typically given before other potassium-lowering treatments. The other choices describe different parts of management (fluids, bicarbonate, or bronchodilator therapy) but do not provide the calcium chloride dose.