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.