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Rhabdomyolysis after prolonged suspension in a cave.

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¹Erlanger Medical Center, Division of Emergency Medicine, University of Tennessee, Chattanooga, TN, USA.

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|March 8, 2011

Summary

Immediate rescue and intravenous fluids are crucial for individuals experiencing suspension trauma. Prompt treatment can prevent severe complications like rhabdomyolysis and kidney failure.

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Area of Science:

Emergency Medicine
Trauma Care
Environmental Health

Background:

Suspension trauma, also known as harness atau positional asphyxia, is a serious risk during activities like caving or climbing.
It occurs when a person is passively suspended for extended periods, leading to physiological distress.
Early recognition and intervention are vital for patient outcomes.

Observation:

A 29-year-old male experienced prolonged suspension (4+ hours) during a caving incident.
Upon rescue, he presented with lower limb weakness and sensory deficits, accompanied by shivering.
Initial field treatment included calcium chloride, normal saline, and bicarbonate.

Findings:

Hospitalization revealed elevated creatine phosphokinase (CPK) levels, indicative of muscle damage.
Intravenous fluid administration led to the resolution of elevated CPK levels.
The case highlights the potential for suspension trauma to cause both early syncope and late-onset rhabdomyolysis.

Implications:

Immediate rescue of passively suspended individuals is paramount to prevent severe outcomes.
Prompt administration of intravenous fluids is essential for mitigating the risk of rhabdomyolysis and subsequent renal failure.
This case underscores the importance of preparedness and rapid response protocols in activities with suspension risks.