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Rhabdomyolysis and Compartment Syndrome

Updated: May 22, 2022


1. Rhabdomyolysis

  • S/S: myalgia (muscle pain), dark red or brown urine.

  • DX: elevated CK, myoglobin, and K+ levels.

  • TX: IVF’s, urine alkalization with sodium bicarbonate, mannitol, dialysis, goal is UO of 100 to 300 ml/hr.

  • Complication – Acute tubular necrosis, hyperkalemia.


2. Compartment syndrome

  • S/S: pain out of proportion, unrelieved by analgesia, on passive movement, shiny taut skin; most occur in lower leg or forearm. Weak or absent pulses are an ominous sign.

  • TX: keep extremity in neutral position (level of heart) if intracompartmental pressure is > 20 mmHg, possible fasciotomy if pressure is > 30.


Resources

· Emergency Nurses Association. Trauma Nursing Core Curriculum, 8th ed., 2019.

· Kent, Kendra. Trauma Certified Registered Nurse Examination Review. Springer, 2017.


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