Moderator EMEDPA Posted July 2, 2013 Author Moderator Share Posted July 2, 2013 Always just thought it was from trauma of any sort, would never in 1000 years thought of the heat aspect. Very cool case. the vast majority of cases I have seen actually have been from dehydration, not trauma. had a good one a few years ago with an elderly guy who fainted in his blackberry bushes in his yard, wasn't able to extricate himself from the bushes and wasn't found for 36 hrs...dry as a bone Link to comment Share on other sites More sharing options...
PM2PA Posted July 2, 2013 Share Posted July 2, 2013 Would the dehydration have anything to do with a now relatively increased serum calcium? Muscles staying contracted microscopically over a long period of time or something like that? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 3, 2013 Author Moderator Share Posted July 3, 2013 would the dehydration have anything to do with a now relatively increased serum calcium? Muscles staying contracted microscopically over a long period of time or something like that? probably...and dehydration coupled with remaining in the same position for an extended period of time leads to muscle breakdown Link to comment Share on other sites More sharing options...
rcdavis Posted July 3, 2013 Share Posted July 3, 2013 another highly rhabdomyolytic event is the little old lady with falls from styrok, mi or whatever, and simply cannot get up, and lies on the floor for 30 plus hours.. her cpk will be way higher than you would expect.. so make sure your lab order sets include total (not just CKMB) CPK.. else you'll miss it. Link to comment Share on other sites More sharing options...
bradtPA Posted July 3, 2013 Share Posted July 3, 2013 the vast majority of cases I have seen actually have been from dehydration, not trauma. had a good one a few years ago with an elderly guy who fainted in his blackberry bushes in his yard, wasn't able to extricate himself from the bushes and wasn't found for 36 hrs...dry as a bone Agreed on the dehydration. My first case ever was in Desert Storm!, 1991, at Khobar Towers. 135 degree heat, and the guy starts weight lifting. Comes in to see me on the night shift complaining of "black urine". Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 3, 2013 Author Moderator Share Posted July 3, 2013 agreed on the dehydration. My first case ever was in desert storm!, 1991, at khobar towers. 135 degree heat, and the guy starts weight lifting. Comes in to see me on the night shift complaining of "black urine". yup, we had an army reserve guy get rhabdo doing crossfit training in the desert. 5 mile laps, pushups, pull ups, situps, etc with minimal fluid intake. His ck was >82,000 Link to comment Share on other sites More sharing options...
Nonlegit Posted July 23, 2013 Share Posted July 23, 2013 EMED do you have any follow up? Curious about the end result....I can empathize with this patient. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 23, 2013 Author Moderator Share Posted July 23, 2013 EMED do you have any follow up? Curious about the end result....I can empathize with this patient. yup, his Cr peaked at 15 then gradually returned to nl. he is back at work. Link to comment Share on other sites More sharing options...
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