Management

1. If respiratory alkalosis is present, adjust ventilator settings or, if spontaneously hyperventilating and agitated, calm ± sedate. Rebreathing into a bag may be beneficial.

2. If symptomatic, give 5-10 ml 10% calcium chloride solution over 2-5 min. Repeat as necessary.

3. Correct hypomagnesaemia or hypokalaemia if present.

4. If asymptomatic and in renal failure or hypoparathyroid, consider enteral/parenteral calcium supplementation and vitamin D analogues.

5. If hypotensive or cardiac output is decreased following administration of a calcium antagonist, give 5-10 ml 10% calcium chloride solution over 2-5 min.

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