Perfect Storm of Life-Threatening Hypocalcemia in a Severe Trauma Patient

The presentations of patients with hypocalcemia varies from an asymptomatic biochemical abnormality to a life-threatening disorder, depending on the severity, duration, and rapidity of development. Hypocalcemia was frequently found in hospitalized patient, but severe low level with life-threatening manifestation in a short period of time rarely occurred. Herein, we reported a trauma patient with ”Perfect Storm” scenario of severe hypocalcemia development. Multiple factors contributed to severe hypocalcaemia, included trauma injury with rhabdomyolysis, hyperphosphatemia, acute renal failure, and blood transfusion. Acute hypocalcemia can result in life-threatening complications such as refractory hypotension and cardiac arrhythmia that need rapid correction. Therefore, carefully observation of the clinical signs and monitoring calcium level is suggested in trauma patients.