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Calcium administration in traumatic haemorrhage is a leading prehospital research priority. 1 Previous studies have demonstrated that both trauma-related ionised hypocalcaemia (iHypoCa) and ionised hypercalcaemia (iHyperCa) are present on arrival in the emergency department, and both are associated with increased mortality and adverse outcomes.2–4 No studies have examined how early calcium disturbances occur and whether calcium disturbances are observed prehospital.2 This makes protocolised calcium replacement without ionised calcium (iCa) measurement challenging as it may undertreat some patients and overtreat others.4 5 All UK Helicopter Emergency Medical Services (HEMS) carry blood products and calcium replacement therapy; a small proportion of HEMS use iCa point-of-care testing (POCT).5 This study is hypothesis-generating and aims to identify whether trauma-related calcium disturbances occur before hospital arrival and whether POCT may have a role in detecting these.