Date of Graduation
Spring 2026
Document Type
Culminating Project
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Committee Chairperson
Jacquelyn Owens, DNP, CRNP, FNP-BC
Committee Member
Scott Armen, MD, FACS, FCCP, FCCM
Abstract
Unintentional injuries have remained the third leading cause of death in the United States since 2015, with the exception of 2020. Of those deaths resulting from traumatic injury, 40% result from hemorrhage and uncontrolled blood loss. Current treatment efforts focus on early, balanced transfusion of blood products and aim to correct metabolic derangements/coagulopathies, while minimizing crystalloid administration. As such, the role hypocalcemia plays in the injury process and the importance of calcium administration in resuscitation efforts has gained traction over recent years. The aim of this retrospective analysis was to assess calcium supplementation in relation to current facility protocol for patients undergoing a massive transfusion protocol. A chart review was conducted on all patients admitted to a level 1 trauma center in Hershey, Pennsylvania who underwent a massive transfusion protocol activation during their hospitalization between January 1, 2025 through December 31, 2025. Approximately 79% of all MTPs meeting criteria provided calcium supplementation as outlined within facility protocol. When accounting for blood product transfusions occurring immediately prior to MTP activation, 66% received adequate calcium repletion. In patients receiving calcium supplementation, approximately 44% of patients achieved normocalcemia. When looking at those who received adequate calcium repletion per MTP protocol, 95% of patients achieved a normal ionized calcium level. This DNP project highlighted an educational opportunity regarding calcium administration among patients receiving large and massive volume blood product transfusions and supported the current protocol ability to achieve normocalcemia at MTP conclusion.
Final Version Confirmation
1
Recommended Citation
Unton, Chrissy, "Retrospective Analysis of Calcium Administration in Patients Undergoing Massive Transfusion Protocol (MTP)" (2026). West Chester University Graduate Theses, Dissertations, and Final Projects. 39.
https://digitalcommons.wcupa.edu/all_capstones/39