• Calcium levels can be high or low during the development of the condition – be wary of using calcium to treat hyperkalaemia
  • 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
  • Fluid status must be monitored closely as patients are easily under or overfilled
  • Early fluid resuscitation must be commenced as soon as possible and preferably pre-hospitally if possible
  • Do not delay renal replacement therapy if other measures fail to correct the metabolic disturbances
  • CK levels do not determine prognosis
  • Skeletal muscle is able to tolerate warm ischaemia for up to 2 hours – after this time damage is often irreversible
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