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Rhabdomyolysis after crush injury — MCCQE Part 1 MCQ

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ModerateTraumaRhabdomyolysis after crush injuryMCCQE Part 1

A 30-year-old construction worker is freed after his leg was trapped for 6 hours. He has dark urine, muscle swelling and creatine kinase of 38,000 U/L. Which of the following is the most appropriate next step?

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Correct answer: E — Aggressive intravenous crystalloid hydration and monitoring for hyperkalaemia and AKI

Crush injury with myoglobinuria and very high CK indicates rhabdomyolysis, requiring early IV fluids to prevent AKI and monitoring for dangerous hyperkalaemia. Pulses do not exclude compartment syndrome or renal risk. Fluid restriction and calcium supplementation are inappropriate unless specific indications exist.

Reference: Canadian emergency medicine practice; ATLS principles