A 60-year-old male is brought to the emergency department after being rescued from a collapsed building. He was trapped under debris for several hours and is now complaining of severe muscle pain and weakness. His urine is dark colored. What is the most critical initial step in managing his condition?
Initiate aggressive fluid resuscitation
Provide pain management with opioid analgesics
Administer sodium bicarbonate to alkalinize the urine
Perform fasciotomy to relieve compartment syndrome
The most critical initial step in managing rhabdomyolysis is aggressive fluid resuscitation to dilute the myoglobin in the bloodstream and prevent kidney damage. Ensuring adequate hydration helps to flush out the myoglobin and other muscle breakdown products that can cause renal failure. Monitoring for electrolyte imbalances and ensuring the patient is not fluid overloaded is also important, but the priority is to initiate fluid therapy.
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BCEN CFRN
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