PFC Podcast: How important is Calcium for Trauma?

Feb 26, 2026

Steve Schauer, active duty U.S. Army lieutenant colonel and critical care fellow, leads a multi-center study on calcium in trauma. They discuss how trauma and prehospital care affect calcium, challenges of trauma research and data collection, differences between military and civilian injuries, timing and formulations for calcium administration, and priorities in resuscitation like blood and TXA.

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ADVICE

Draw Calcium Before Hospital Blood Starts

For the study draws they obtained a blood sample immediately on arrival before hospital products to ensure arrival calcium was unconfounded.
They used rapid femoral sticks or IOs to get that pre-product sample even when access was difficult.

INSIGHT

Large Enrollment Despite 24-Hour Draw Challenges

Enrollment exceeded initial targets: about 900 arrival-calcium samples and over 400 with most 24-hour draws.
Logistical difficulty getting serial 24-hour calcium values forced oversampling for the primary outcome.

INSIGHT

Downrange Data Shows Frequent Calcium Abnormalities

Retrospective DODTR data showed over half of ~2,000 draws had a calcium derangement on ED arrival, with both hypo- and hypercalcemia observed.
Associations existed between calcium abnormalities and physiologic derangements and transfusion categories, but timing limits causal inference.

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In this episode of the PFC podcast, Dennis interviews Steve, an active duty member of the US Army and a critical care fellow at the University of Colorado Denver. They discuss a recent study on calcium levels in trauma patients, exploring the effects of trauma on calcium derangements, the challenges of conducting trauma research, and the importance of pre-hospital care. Steve shares insights on the administration of calcium in emergency settings, the prioritization of treatments in trauma care, and the future of research in this area.

Takeaways

Calcium levels can be affected by trauma and pre-hospital care.
The study aims to determine how many trauma patients arrive with calcium derangements.
Data collection in trauma research can be logistically challenging.
Calcium is essential for the coagulation cascade in trauma patients.
TXA is important for preventing the breakdown of clots during trauma care.
Prioritizing blood transfusions is critical in trauma situations.
Understanding the differences between military and civilian trauma is essential for research.
The study has exceeded its enrollment goals, indicating strong interest in the topic.
Future research will provide more concrete data on calcium's role in trauma care.
Medical practices and recommendations continue to evolve based on new research findings.

Chapters

00:00 Introduction to the Calcium Study

02:58 Understanding Calcium's Role in Trauma

06:03 Challenges in Trauma Research

08:56 Pre-Hospital Care and Calcium Levels

11:56 Data Collection and Patient Enrollment

15:12 Calcium Derangements in Trauma Patients

17:47 Calcium Administration in Emergency Settings

21:01 Prioritizing Treatment in Trauma Care

24:12 Future Research and Conclusion

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