Rhabdomyolysis: an overview for pre-hospital clinicians
Abstract
Rhabdomyolysis is a potentially life-threatening condition that occurs when muscle tissue breaks down, leading to the release of the cellular contents into the circulation. There are broad ranges of causes for this, both physical and non-physical.
This article aims to introduce pre-hospital clinicians to what rhabdomyolysis is, the causes of the condition, and also discusses the implications for pre-hospital practice before outlining management.
The authors highlight how many of the causes for the condition are frequently encountered in pre-hospital practice and how even those cases which may appear initially simple, such as the elderly fall, can be complicated by rhabdomyolysis in as little as an hour.
Finally, recommendations are made for more work to be undertaken to understand the frequency with which patients encountered by ambulance services go on to develop this condition, as well as encouraging those responsible for producing national guidelines to include this condition in their future publications.
Rhabdomyolysis is a medical condition caused by the breakdown of skeletal muscle with leakage of intracellular contents into the circulation (Khan, 2009). It can range in severity from a benign asymptomatic illness to a life-threatening condition with a broad range of severe complications including acute renal failure (ARF) (Huerta-Alardin et al, 2005).
The causes of rhabdomyolysis are diverse, but as this article will outline, a number are relevant to the pre-hospital practitioner and for this reason the authors will go on to recommend that those practicing in the pre-hospital environment should have a basic understanding of this condition.
This is not meant as a definitive guide to rhabdomyolysis, many of which have already been produced (Khan, 2009), but more as an introduction for those pre-hospital clinicians not currently familiar with the condition.
As well as considering what rhabdomyolysis is the authors will discuss the implications for pre-hospital practice, before going on to make future recommendations for the inclusion of this condition as a frequent differential, especially in those at-risk patient groups.
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