Authors: Sophie Lewis / Editor: Nicholas Tilbury / Reviewer: Syed Ali Junaid Gillani / Codes: PC3, PhC1, PhP2, SLO1, SLO2, TC1 / Published: 16/04/2020 / Reviewed: 13/04/2025
A 38-year-old gentleman presents confused and drowsy. He has a background of fibromyalgia and previous IV drug abuse. His regular medications include zomorph, oramorph, diazepam and zopiclone.
The patient attended the Emergency Department (ED) with a swollen left calf the previous day when he was treated for a DVT, which was confirmed on a doppler ultrasound.
His observations are stable. Bloods show urea of 48 and creatinine of 899 and he has a creatinine kinase of 102,5788. ABG shows metabolic acidosis. The patient does not complain of pain but his left lower limb is swollen and tense. He is unable to dorsiflex and tells you he can’t feel his left leg.