Preventing Hypocalcemia in Major Trauma - A QIP in a Major Trauma Centre in UK

Abstract

INTRODUCTION Addenbrookes is a major trauma centre in the UK dealing with trauma of all ages and mechanisms. Major trauma is often complicated by hypocalcaemia which we have recognised that is often under-recognized and under-corrected. AIMS / OBJECTIVES To improve the knowledge gap among clinicians concerning hypocalcaemia as a complication of Major Trauma. MATERIALS / METHODS Utilising the PDSA cycle, we initially retrospectively reviewed the notes of over 40 major trauma patients between August 2022 and January 2023 and carried out a clinician's survey. Following a period of formal teaching and education in October regarding hypocalcaemia as a complication of major trauma, the clinician survey was repeated. RESULTS In the initial survey, only 25% of clinicians recognized hypocalcaemia in major trauma - potentially leading to poorer patient outcomes. Following the implementation of the teaching programme, the incidence of clinicians recognizing hypocalcaemia rose to 75%. The prevalence of calcium prescribing by clinician's also rose from a trough level of 16% pre-education to 60% post-education DISCUSSION While hemorrhage in major trauma leads to calcium loss, resuscitation with blood products contributes to hypocalcaemia through citrate induced calcium chelation. CONCLUSION Hypocalcaemia is an under-recognised complication of major trauma and education helps to promote it's correction.