Emergency MedicineRenal
Rhabdomyolysis
CK ≥5× ULN with myalgia / dark urine / AKI — aggressive fluid resuscitation, electrolyte management, identify cause.
Source: Renal Association 2018; UpToDate 2024
Used in: Acute Kidney Injury
Step 1 of ~5
info
Recognise & Investigate
Triggers: trauma/crush, prolonged immobilisation (long-lie), seizures, exertion, statins/fibrates, alcohol/drug intoxication (cocaine, MDMA, opioids), infections, electrolyte derangements, NMS / serotonin syndrome.
• Bloods: CK (typically >5000 IU/L), U&E, K⁺, Ca²⁺, PO₄, urate, ABG, lactate, FBC, coag, myoglobin (urine if available — dipstick haem +ve, no RBC on microscopy).
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Potassium chloride with calcium chloride and sodium chloride · Crystalloid IV fluid
- Potassium chloride with calcium chloride sodium chloride and sodium lactate · Balanced crystalloid IV fluid
- Potassium chloride with glucose · IV fluid (potassium + dextrose)
- Potassium chloride with glucose and sodium chloride · IV fluid (mixed)
- Potassium chloride with sodium chloride · IV fluid (potassium + saline)
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
A deeper exam-focused version of this pathway is available on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only. Always apply local guidelines and clinical judgement.