ck of > 26,ooo

Specialties Emergency

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Specializes in Emergency Room.

Had a guy admitted the other day with a ck of >26,000. :imbar HX. htn, and hyperlipidemia. took bp pill and zocor. He just started the zocor 2 months ago. (remember Baychol?) Anyway, he had just started an excersize regimen the previous day. Trainer decided he should start (start!) with 2 hours per day. The day of admission, he had just completed 1/2 hr of cardio workout, and was laying on the mat doing situps when he had a "near syncope" episode. (Dizzy, lightheaded, nausea). Brought to our ER by ambo. I asked the doc why he thought the CK would be so high? LFT's were elevated, CK-MB was 4.something. Trop was negative. Guy had absolutely no S/S whatsoever. Then I remembered baychol. Or baycol. Whatever. (nice pens). Looked it up on the internet, and found that any of the statins can cause rhabdo. Told the doc. pat self on back. :)

Any others with CK's like this? with statins still on the market? I mean, the exercise might have contributed, but 2 days worth? Guy was mid 50's and weighted 243#.

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The only time I have seen CPKs in that range were from rhabdo and back then we didn't have all of these newer products. My patients had gotten it the old fashioned way; they were very, very sick.

I will add your post to what I tell my students.

Thanks for the info.

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Specializes in ICU.

Ditto and double ditto!!!

Nice work!!!

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Good job! I learned something. I've seen a few cases of rhabdo, usually in patients who come in and were "found down" at home a long period of time. I had no idea it could be caused by a medication. :)

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Specializes in ER, ICU, L&D, OR.
Good job! I learned something. I've seen a few cases of rhabdo, usually in patients who come in and were "found down" at home a long period of time. I had no idea it could be caused by a medication. :)

also by McCardles syndrome, causes chronic Rhabdo

I know apt on disability due to it

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Specializes in Emergency Room.

http://members.aol.com/itsgumby/About.html

ok, so then I had to look up Mcardle's syndrome :)

Amazing, day to day, that despite how much you think you know........everyday there is something new. Not like that job that Lucy had with the chocolates on the conveyor belt. :chuckle

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Specializes in Emergency Room/corrections.

Congrats Diane! Great call!

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Good call..I love when we can show the docs how smart we are. I work at an urgent care department. Last week we had a new doc very smart but not used to fast pace and was hurried. We had a young female with some sob but had ok sats. I listened to her lungs and could hear nothingin the left side. Told the doc but she said the pt. was diminished and ordered a neb. tx befor a chest xray. Wellllll the chest xray showed a giant pneumo. I was proud yet embarrassed for the doc. Go figure....

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Specializes in Emergency Room.

yet inside, don't you love that? I had a patient a long time ago that had been in the hospital for dx of pyelonephritis. she's been there for about a week :uhoh3: . Looking at my MAR's at the beginning of the shift, I see IV fluids, nausea and pain meds...........no abx's! Looked back, and she had missed 48 hours of cipro iv because our pharmacy has a "hard stop" on certain abx, and will not fill until dr. writes new order for same. I had to call him and notify him of same. Could've held the phone 2 feet from my ear and still hear him rant. Had to remind him #1, I've not ever taken care of this patient before, #2, notes had been put on the chart for him to re-order med, and #3 it is only 1/2 hour into my shift! He appologized, and she got her cipro. (turns out she didn't even have pyelo in the first place, and was soon d/c'd) HA!

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Specializes in Emergency Room.

Since I'm in this mode............I once had a post op patient that the doc wrote "ambulate tonoc, and the bid" My aide and I strugged to get this patient out of bed, made it to the door, barely, and back to bed. Found out (after we had tucked him in) that he had been a paraplegic almost all of his adult life, and was wheelchair bound. :imbar

Then, had a post TURP pt. This doc always wrote the same orders on every one of his patients, so I knew I had to get him up into a chair that night after surgery. DId just that...........put him back to bed. Next day, I am getting my a## reamed by mister/doctor/shortman syndrome urologist because "the patient told me you did NOT get him up last night!" Well........... :angryfire I sure did! and had nursing assistant who helped me there to testify. The patient was still grogged from anesthesia and didn't even remember being in the chair! HA!

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Had a guy who had a level >80,000 for over three days but his was related to too many squats at the gym. Never seen a statin cause ck quite that high though.

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Good job! I learned something. I've seen a few cases of rhabdo, usually in patients who come in and were "found down" at home a long period of time. I had no idea it could be caused by a medication. :)

Tweety,

Saw my first case of rhabo last week -- same scenario, pt FDWB, son found her about 8 hours down and she had a CK of >27,000.

She had that rhabo urine color too -- weird. Love the ER. Learn so much every day.

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