Acute Rhabdomyolysis?

chris_at_lucas_RN, RN · Aug 18, 2004

I do seem to recall that the patient's pain is what the patient says it is, and that we are to manage the pain, not worry about the patient's history.

Not meaning to be critical of the poster....

Someone with a history of dependence or abuse may need more attention to their pain management, not less.

It isn't as though she was making up the rhabdo or the fasciotomies.

cnyrn · Aug 18, 2004

Scrawny, little guy in his 30's, wanted to "bulk up", lifting lot's of weights and taking protein supplements (vague about type and amount) adm. to fllor a couple years ago with rhabdo,.Lots of pain, angry and un co-op with staff and MD. Sent him to the unit, unsure of outcome.

talaxandra · Aug 19, 2004

And I thought our OD with a CK of 25,000 was impressive!

I've looked after a couple of dozen patients with rhabdo and, as previously posted, they tend to come in a couple of flavours: illicit drug OD, dehydrated athletes, and frail elderly collapses during summer.

Our latest OD had a high above knee amp after fasciotomies were unsuccessful; she's come to realise that she's lucky - at least she got her renal function back.

The worst elderly collapse rhabdo we had stroked out in the bathroom and wasn't found for three days, in the height of (an Australian) summer - she had urine burns in the shape of the grouting of her bathroom floor (teeny tiny tiles) and ended up having her whole flank debrided and grafted.

The most unlikely one was also a woman - previously unfit, she decided to embark on an intensive fitness program as a New Year resolution. February gets really hot down here - she was brought in after running for three hours in the midday sun, already dehydrated bfore she started because she'd been on a cleansing juice fast and had diuresed herself half to death to begin with. A passerby called for an ambulance because she was incoherent and sunburned, and then they got the labs back...

Good news is she got a kidney transplant about six months ago and is doing really well.