In this episode, we explain calcium repletion during blood transfusion, focusing on citrate toxicity, dosing strategies, and practical clinical management. Designed for nursing students, ICU clinicians, and emergency and critical care professionals, this episode provides a clear, step-by-step guide to understanding how massive or rapid transfusion can affect calcium levels and why timely correction is critical for patient safety. We review the pathophysiology of citrate toxicity, how it leads to hypocalcemia, and the clinical signs you need to recognize at the bedside. You’ll learn when to administer calcium, how to choose between calcium chloride and calcium gluconate, and how to dose and monitor repletion during transfusion. With real-world clinical insights and practical tips, this episode helps you confidently manage calcium balance in high-acuity situations. Topics covered include: • Overview of citrate toxicity during blood transfusion • How hypocalcemia develops and its clinical impact • Signs and symptoms of transfusion-related hypocalcemia • Indications for calcium repletion • Calcium chloride vs. calcium gluconate selection • Dosing strategies and monitoring considerations • Practical bedside management tips Whether you’re preparing for exams, orienting to critical care, or strengthening your transfusion management skills, this episode delivers a clear and actionable guide to calcium repletion in acute care settings. 📚 Download the PDF study guide for this video: 👉 https://www.patreon.com/c/WhiteBoardMedicine Patreon members get access to mini-courses, study guides, practice questions, ad-free videos, and in-depth educational discussions designed for emergency and critical care clinicians. Critical Care Basics to Advanced Playlist https://youtube.com/playlist?list=PLf5bMa9_tvRjOMmnully6zFShzvh_ptiI&si=gwl_jVCzNxboxt6G Disclaimer: This podcast is intended for educational and informational purposes only and does not constitute medical advice, diagnosis, or treatment. The content should not be used as a substitute for professional clinical judgment or consultation with a qualified healthcare provider. The creators and hosts assume no responsibility or liability for any actions taken based on the information presented in this episode.

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