Pitfalls
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Calcium levels can be high or low during the development of the condition – be wary of using calcium to treat hyperkalaemia
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The increase in serum potassium appears to be most marked during the first 12-36 hours after muscle injury. Treat potassium levels with caution – remember the ECG changes are non-specific
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Fluid status must be monitored closely as patients are easily under or overfilled
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Early fluid resuscitation must be commenced as soon as possible and preferably pre-hospitally if possible
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Do not delay renal replacement therapy if other measures fail to correct the metabolic disturbances
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CK levels do not determine prognosis
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Skeletal muscle is able to tolerate warm ischaemia for up to 2 hours – after this time damage is often irreversible
