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Combat trauma can cause acute kidney injury (AKI) and hyperkalemia. This guideline prepares deployed providers to manage AKI and hyperkalemia in austere environments when advanced care is unavailable.

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Area of Science:

  • Emergency Medicine
  • Nephrology
  • Military Health

Background:

  • Acute kidney injury (AKI) is a known complication of combat trauma.
  • Life-threatening hyperkalemia associated with AKI typically has a delayed onset.
  • Past conflicts allowed for evacuation to higher echelons of care with renal replacement therapies.

Purpose of the Study:

  • To provide recommendations for managing AKI and hyperkalemia in austere, deployed settings.
  • To prepare providers for situations lacking advanced renal replacement therapies.
  • To address the unique challenges of critical care in combat environments.

Main Methods:

  • Development of a clinical practice guideline.
  • Focus on management strategies for AKI and hyperkalemia.
  • Consideration of resource limitations in deployed environments.

Main Results:

  • Guidelines offer strategies to "temporize" patients awaiting transport.
  • Addresses the proactive management of at-risk individuals.
  • Emphasizes preparedness for delayed complications in austere settings.

Conclusions:

  • Deployed providers must be prepared to manage AKI and hyperkalemia without immediate access to advanced care.
  • This guideline provides a framework for critical decision-making in austere environments.
  • Proactive management and temporizing strategies are crucial for patient survival.