A pre-hospital focus on rhabdomyolysis in elderly falls

Rhabdomyolysis is a life-threatening condition—and not one that is factored into a clinical diagnosis in pre-hospital cases often enough. The author's experience of such cases in clinical practice has guided further investigation and exploration of published literature to create an opportunity to learn about the condition, and raise much-needed awareness that people die from the untreated complications of rhabdomyolysis—and providers of pre-hospital care have a role to play in helping to identify it. This comment article will briefly review current practice and evidence, and highlight the need for further research and study into a rather alien condition.

To confidently recognise the clinical presentation of rhabdomyolysis, clinicians need to understand the pathophysiological changes that occur, and the symptoms such changes create. Rhabdomyolysis, by definition, is skeletal muscle breakdown where cellular contents are released into the circulating blood plasma including creatinine kinase (CK) and myoglobin. There are two pathways which commonly lead to the release of cellular contents.