During cardiopulmonary resuscitation, intravenous calcium gluconate is indicated under all of the following circumstances except -
After initial unsuccessful defibrillation attempts or with persistent/recurrent electrical instability, antiarrhythmic therapy should be instituted. Intravenous amiodarone has emerged as the initial treatment of choice (150 mg over 10 min, followed by 1 mg/min for up to 6 h and 0.5 mg/min thereafter). For cardiac arrest due to VF in the early phase of an acute coronary syndrome, a bolus of 1 mg/kg of lidocaine may be given intravenously as an alternative, and the dose may be repeated in 2 min. It also may be tried in patients in whom amiodarone is unsuccessful. Intravenous procainamide (loading infusion of 100 mg/5 min to a total dose of 500-800 mg, followed by continuous infusion at 2-5 mg/min) is now rarely used in this setting but may be tried for persisting, hemodynamically stable arrhythmias. Intravenous calcium gluconate is no longer considered safe or necessary for routine administration. It is used only in patients in whom acute hyperkalemia is known to be the triggering event for resistant VF, in the presence of known hypocalcemia, or in patients who have received toxic doses of calcium channel antagonists. ref:harrison&;s principles of internal medicine,ed 18,pg no 2244
After 1 minute of arrest routinely
Hypocalcemia
Calcium channel blockers toxicity
Electromechanical dissociation
C.V.S