A 45-year-old man is trapped under machinery on a remote property for 4 hours before extrication. In ED, triage category 1, he has thigh swelling,

Question

A 45-year-old man is trapped under machinery on a remote property for 4 hours before extrication. In ED, triage category 1, he has thigh swelling, dark urine and peaked T waves. Potassium is 7.1 mmol/L, CK is 36,000 U/L and creatinine is 180 micromol/L. What is the most appropriate management?

Accepted Answer

IV calcium, insulin-dextrose and aggressive isotonic fluids

Answer

Apply tight compression bandaging

Answer

Give oral potassium replacement

Answer

Restrict fluids until creatinine normalises

Answer

Arrange delayed outpatient renal tests

Crush syndrome with hyperkalaemia — ACEM Fellowship MCQ

A 45-year-old man is trapped under machinery on a remote property for 4 hours before extrication. In ED, triage category 1, he has thigh swelling, dark urine and peaked T waves. Potassium is 7.1 mmol/L, CK is 36,000 U/L and creatinine is 180 micromol/L. What is the most appropriate management?