Rhabdomyolysis: The Daily PANCE Blueprint

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Rhabdomyolysis: The Daily PANCE Blueprint

A 45-year-old man is brought to the emergency department by his wife after being found unresponsive in his garage. He had been working on his car in a poorly ventilated space for several hours. On arrival, he is confused and disoriented. His blood pressure is 90/60 mmHg, heart rate is 110 bpm, and temperature is 37.8°C (100°F). Physical examination reveals muscle tenderness and dark-colored urine. Laboratory tests show a serum creatine kinase (CK) level of 20,000 U/L, serum potassium of 5.8 mEq/L, and serum creatinine of 2.5 mg/dL. Urinalysis is positive for myoglobin. Which of the following is the most appropriate initial management for this patient?

A. Intravenous sodium bicarbonate
B. Hemodialysis
C. Intravenous normal saline
D. Intravenous mannitol
E. Oral potassium supplementation

Answer and topic summary

The answer is C. Intravenous normal saline

The most appropriate initial treatment for rhabdomyolysis is aggressive intravenous fluid resuscitation. The primary goal is to maintain renal perfusion and promote the excretion of myoglobin to prevent acute kidney injury. Isotonic saline is typically used, and fluids should be administered at a high rate to achieve a urine output of at least 200-300 mL/hour.

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Covered under ⇒ PANCE Blueprint Renal System ⇒ Rhabdomyolysis

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