Consecutive administration of multiple units of banked blood overwhelms the body's ability to mobilize free calcium and causes a marked reduction in circulating serum calcium with a profound negative inotropic effect on the heart.
unrecognized hypocalcaemia is a common cause of hypotension that persists despite an adequate volume of resuscitation.
Ionized calcium levels should be measured at regular intervals in a hemorrhaging patient, and calcium should be administered as needed (in a separate intravenous line from That for transfusion products)
